Active NPI
Ava Petersen
- Behavior Technician
- Sycamore, IL
National Provider Identifier
1467331058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-24-343956
- Practice address
- 920 S Prairie Dr Unit G
Sycamore, IL 60178 - Phone
- (779) 269-4065
- NPI assigned
- Aug 28, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assistant Behavior Analyst | 106E00000X | IL | ||
| Behavior Technician | 106S00000X | RBT-24-343956 | IL | Primary |
Addresses
Primary practice location
920 S Prairie Dr Unit G
Sycamore, IL 60178
Mailing address
3920 Washington St
Downers Grove, IL 60515-2127
Phone (614) 746-0517
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-24-343956 | IL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778716800000",
"number": "1467331058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3920 WASHINGTON ST",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605152127",
"telephone_number": "614-746-0517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 S PRAIRIE DR UNIT G",
"city": "SYCAMORE",
"state": "IL",
"postal_code": "60178",
"telephone_number": "779-269-4065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "AVA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-08-28",
"last_updated": "2026-05-14",
"certification_date": "2026-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": "IL",
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": "RBT-24-343956",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sycamore, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.