Individual provider Active NPI

Wendy Myers, RBT

  • Behavior Technician
  • Yorkville, IL
National Provider Identifier
1619467966
Registry record updated May 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
17-43376 Issued in IL
Practice address
3931 Havenhill CT
Yorkville, IL 60560-4705
Phone
(630) 779-8860
NPI assigned
May 12, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 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 17-43376 IL Primary

Addresses

Primary practice location

3931 Havenhill CT
Yorkville, IL 60560-4705

Mailing address

3931 Havenhill CT
Yorkville, IL 60560-4705

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
17-43376ILMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1526083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526083200000",
    "number": "1619467966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3931 HAVENHILL CT",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605604705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3931 HAVENHILL CT",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605604705",
            "telephone_number": "630-779-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "WENDY",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-12",
        "last_updated": "2018-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "17-43376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorkville, IL

Sources for this page

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