Shannon Marie Collins

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

C452-7939-1872 Issued in IL

Practice address

5304 Grand Ave
Western Springs, IL 60558-1838

Phone

(715) 497-4416

NPI assigned

Oct 28, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Abc Therapy Clinics

  • Behavior Analyst
  • Western Springs, IL
  • NPI 1518508977
  NPD (past)
• Applied Behavioral Consulting

  • Behavior Analyst
  • Western Springs, IL
  • NPI 1164891750
  NPD (past)

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

{
    "created_epoch": "1477612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1609328285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5304 GRAND AVE",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5304 GRAND AVE",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581838",
            "telephone_number": "715-497-4416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-28",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "C452-7939-1872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christy K Furey MD SC
• Amanda Ciolek
• Michele Anne Cioper, MSW
• Clarity Physical Therapy and Wellness Center, LLC
• Nancy Coleman
• Michael P Colucci, BALAS
• Combs Eyecare and Eyewear LTD
• Irene D Combs, O.D.
• Nicole Conteduca
• Amy Coots-Smith, LCPC

• Behavior Analyst in Western Springs, IL
• Providers in Western Springs, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; 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.