Active NPI
Jennifer Doherty
- Behavior Analyst
- Park Ridge, IL
National Provider Identifier
1477998763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 911 W Talcott Rd
Park Ridge, IL 60068-4740 - Phone
- (847) 702-0709
- NPI assigned
- May 1, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
911 W Talcott Rd
Park Ridge, IL 60068-4740
Mailing address
911 W Talcott Rd
Park Ridge, IL 60068-4740
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367366400000",
"number": "1477998763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "911 W TALCOTT RD",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600684740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "911 W TALCOTT RD",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600684740",
"telephone_number": "847-702-0709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOHERTY",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-01",
"last_updated": "2013-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.