Individual provider Active NPI

Debra Locklear

  • Behavior Technician
  • Glendale Heights, IL
National Provider Identifier
1578054672
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
17-41410 Issued in IL
Practice address
2159 Pepperwood LN
Glendale Heights, IL 60139-1734
Phone
(630) 924-4948
NPI assigned
May 23, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 17-41410 IL Primary

Addresses

Primary practice location

2159 Pepperwood LN
Glendale Heights, IL 60139-1734

Mailing address

2159 Pepperwood LN
Glendale Heights, IL 60139-1734
Phone (630) 924-4948

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

State licenses

LicenseStateTypeSpecialty
17-41410ILMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1578054672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2159 PEPPERWOOD LN",
            "city": "GLENDALE HEIGHTS",
            "state": "IL",
            "postal_code": "601391734",
            "telephone_number": "630-924-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2159 PEPPERWOOD LN",
            "city": "GLENDALE HEIGHTS",
            "state": "IL",
            "postal_code": "601391734",
            "telephone_number": "630-924-4948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKLEAR",
        "first_name": "DEBRA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-23",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "17-41410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; 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.