NPIMap

Organization Active NPI

Early Intervention for Autism, LLC.

  • Behavior Analyst
  • Glenview, IL
National Provider Identifier
1477960508
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-10-7063
Legal business name
EARLY INTERVENTION FOR AUTISM, LLC.
Practice address
2452 Violet St
Glenview, IL 60026-8032
Phone
(847) 915-0164
NPI assigned
Jul 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

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

Authorized official

Name
Jennifer Jane Mihm, BCBANPI 1609147818
Title
Clinical Director
Phone
(847) 915-0164

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1-10-7063 Primary

Addresses

Primary practice location

2452 Violet St
Glenview, IL 60026-8032

Mailing address

2452 Violet St
Glenview, IL 60026-8032
Phone (847) 915-0164

National Provider Directory

National Provider Directory
Tax ID family
Early Intervention for Autism LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405900800000",
    "number": "1477960508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2452 VIOLET ST",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268032",
            "telephone_number": "847-915-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2452 VIOLET ST",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268032",
            "telephone_number": "847-915-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARLY INTERVENTION FOR AUTISM, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-21",
        "last_updated": "2014-07-21",
        "status": "A",
        "authorized_official_last_name": "MIHM",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "847-915-0164",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-10-7063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.