Individual provider Active NPI

Arthur Felipe Jimenez, MS, MA, BCBA, LPC

  • Behavior Analyst
  • Crestwood, IL
National Provider Identifier
1619334240
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-15-18950 Issued in IL
Practice address
12745 Central Ave
Crestwood, IL 60418-1130
Phone
(708) 722-2384
Fax
(708) 926-9250
NPI assigned
Jan 27, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 178.019800 IL
Behavior Analyst 103K00000X 1-15-18950 IL Primary

Addresses

Primary practice location

12745 Central Ave
Crestwood, IL 60418-1130

Mailing address

12745 Central Ave
Crestwood, IL 60418-1130
Phone (708) 722-2384

Other practice location 1

2455 N Halsted St # 1S
Chicago, IL 60614-7546
Phone (708) 921-1261

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, Master of Science

State licenses

LicenseStateTypeSpecialty
178.019800ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Behavior, Education, Training, Healthcare, LTD Current Accepting new patients

Organizations & group practices 1

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": "1453852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1619334240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12745 CENTRAL AVE",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "604181130",
            "telephone_number": "708-722-2384",
            "fax_number": "708-926-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12745 CENTRAL AVE",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "604181130",
            "telephone_number": "708-722-2384",
            "fax_number": "708-926-9250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2455 N Halsted St # 1S",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606147546",
            "country_code": "US",
            "telephone_number": "708-921-1261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ARTHUR",
        "middle_name": "FELIPE",
        "credential": "MS, MA, BCBA, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-27",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.019800",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-15-18950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestwood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.