Kazu Takeguchi

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

3022 S Park Ave
Herrin, IL 62948-3721

Phone

(618) 967-1567

NPI assigned

Oct 13, 2011

Sex

Female

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Specialized Training for Adult Rehabilitation, Inc

  • Developmentally Disabled Services Day Training Agency
  • Murphysboro, IL
  • NPI 1174997779
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 15, 2023.

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1487939146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3022 S PARK AVE",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3022 S PARK AVE",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483721",
            "telephone_number": "618-967-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKEGUCHI",
        "first_name": "KAZU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-13",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madyson T Swain, RBT
• Kayla Renae Szczeblewski
• Gregory Szych, DO
• Anna Szyfer, FNP-C
• Deanna L. Tacderas, APN
• Tiffany Eve Tamasfi, DNP
• Allison Marie Tanner, M.S., SLP-CCC
• Krista Teckenbrock
• Kati Terry, PT
• Lisa Ann Thomas-Hopkins, SLP

• All providers in Herrin, IL
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.