Active NPI
Nicole Ann Denman
- Behavior Technician
- Lakemoor, IL
National Provider Identifier
1588145056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 1848989
- Practice address
- 316 Venice Rd
Lakemoor, IL 60051-8648 - Phone
- (847) 767-4414
- NPI assigned
- Aug 23, 2018
- Last updated
- Aug 23, 2018
- Sex
- Female
- Sole proprietor
- No
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 Technician | 106S00000X | 1848989 | KY | Primary |
Addresses
Primary practice location
316 Venice Rd
Lakemoor, IL 60051-8648
Mailing address
316 Venice Rd
Lakemoor, IL 60051-8648
Phone (847) 767-4414
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1848989 | KY | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534982400000",
"number": "1588145056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "316 VENICE RD",
"city": "LAKEMOOR",
"state": "IL",
"postal_code": "600518648",
"telephone_number": "847-767-4414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 VENICE RD",
"city": "LAKEMOOR",
"state": "IL",
"postal_code": "600518648",
"telephone_number": "847-767-4414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENMAN",
"first_name": "NICOLE",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-23",
"last_updated": "2018-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "KY",
"license": "1848989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakemoor, IL
- Ralitza Anguelova, PHARMD
- Jennifer Barruffi
- Melissa Boger, ATC, CSCS, NASM-PES
- Hannah Marie Callender, DMD
- Jake Ryan Debosschere, DO
- Dental Professionals of Illinois, P.C. (Dental Care at Lakemoor Commons)
- Yatri Desai, DO
- Josette Dutcher, APRN-BC, FNP
- Raman Deep Kaur, FNP
- Jennifer Cynthia Kubacik, OT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.