Individual provider Active NPI

Nicole Palumbo, M.A., BCBA

  • Behavior Analyst
  • Chicago, IL
National Provider Identifier
1508692864
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
8609 W Bryn Mawr Ave Ste 204
Chicago, IL 60631-3524
Phone
(630) 401-6852
NPI assigned
Sep 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X IL Primary

Addresses

Primary practice location

8609 W Bryn Mawr Ave Ste 204
Chicago, IL 60631-3524

Mailing address

8609 W Bryn Mawr Ave Ste 204
Chicago, IL 60631-3524
Phone (773) 644-7787

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
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Djje Holdings LLC Behavior Analyst Past Accepting new patients
The Place for Speech Therapy LLC Past Accepting new patients
Autism Evaluation Center at the Place Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1726099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1508692864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8609 W BRYN MAWR AVE STE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313524",
            "telephone_number": "773-644-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8609 W BRYN MAWR AVE STE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313524",
            "telephone_number": "630-401-6852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALUMBO",
        "first_name": "NICOLE",
        "credential": "M.A., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-12",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.

Verify at the official NPI Registry.