Active NPI
Kelaiah Todd
- Behavior Analyst
- Tinley Park, IL
National Provider Identifier
1487402889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 7050 Centennial Dr
Tinley Park, IL 60477-1649 - Phone
- (773) 425-5677
- NPI assigned
- May 9, 2024
- 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
7050 Centennial Dr
Tinley Park, IL 60477-1649
Mailing address
363 E 169TH PL
South Holland, IL 60473-2955
Phone (773) 425-5677
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": "1715212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715212800000",
"number": "1487402889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "363 E 169TH PL",
"city": "SOUTH HOLLAND",
"state": "IL",
"postal_code": "604732955",
"telephone_number": "773-425-5677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7050 CENTENNIAL DR",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604771649",
"telephone_number": "773-425-5677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TODD",
"first_name": "KELAIAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-09",
"last_updated": "2024-05-09",
"certification_date": "2024-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tinley Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.