Individual provider Active NPI

Lori Lea Mize, RBT-18-47299

  • Behavior Technician
  • Lake in the Hills, IL
National Provider Identifier
1477042034
Registry record updated May 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-18-47299 Issued in IL
Practice address
4185 Greenfield LN
Lake in the Hills, IL 60156-5515
Phone
(847) 651-4185
NPI assigned
May 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-18-47299 IL Primary

Addresses

Primary practice location

4185 Greenfield LN
Lake in the Hills, IL 60156-5515

Mailing address

4185 Greenfield LN
Lake in the Hills, IL 60156-5515
Phone (847) 651-4185

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

LicenseStateTypeSpecialty
RBT-18-47299ILMDBehavior Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1477042034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4185 GREENFIELD LN",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601565515",
            "telephone_number": "847-651-4185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4185 GREENFIELD LN",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601565515",
            "telephone_number": "847-651-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZE",
        "first_name": "LORI",
        "middle_name": "LEA",
        "credential": "RBT-18-47299",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "RBT-18-47299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake in the Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.