Active NPI
Jackie T. Hardenbergh, MA, BCBA
- Behavior Analyst
- Oak Park, IL
National Provider Identifier
1467600171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-09-6132
- Practice address
- 115 S Marion St
1St Floor
Oak Park, IL 60302-2826 - Phone
- (708) 358-3000
- Fax
- (708) 524-0300
- NPI assigned
- Sep 5, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-09-6132 | IL | Primary |
Addresses
Primary practice location
115 S Marion St
1St Floor
Oak Park, IL 60302-2826
Mailing address
115 S Marion St
1St Floor
Oak Park, IL 60302-2826
Phone (708) 358-3000
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
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263945600000",
"number": "1467600171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 S MARION ST",
"address_2": "1ST FLOOR",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603022826",
"telephone_number": "708-358-3000",
"fax_number": "708-524-0300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 S MARION ST",
"address_2": "1ST FLOOR",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603022826",
"telephone_number": "708-358-3000",
"fax_number": "708-524-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARDENBERGH",
"first_name": "JACKIE",
"middle_name": "T.",
"name_prefix": "Ms.",
"credential": "MA, BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-05",
"last_updated": "2010-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IL",
"license": "1-09-6132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.