Individual provider Active NPI

Kathleen Norris, BCBA

  • Behavior Analyst
  • Oswego, IL
National Provider Identifier
1619497351
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-17-26160 Issued in IL
Practice address
412 Sudbury Cir
Oswego, IL 60543-7149
Phone
(630) 362-5979
NPI assigned
Jun 23, 2017
Last updated
Sep 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X BA-190 HI
Behavior Analyst 103K00000X 1-17-26160 IL Primary
Behavior Analyst 103K00000X 152000275 IL

Addresses

Primary practice location

412 Sudbury Cir
Oswego, IL 60543-7149

Mailing address

412 Sudbury Cir
Oswego, IL 60543-7149
Phone (630) 362-5979

Other practice location 1

220 E Roosevelt Rd
Villa Park, IL 60181-3500
Phone (630) 601-8625

Other identifiers 3

IdentifierTypeStateIssuer
1-17-26160OtherBEHAVIOR ANALYST CERTIFICATION BOARD (BACB)
BA-190OtherHIDCCA
152000275OtherILIDFPR

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
BA-190HIMDBehavioral Analyst
152000275ILMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Superhero Behavior LLC Behavior Analyst CurrentSince Nov 13, 2022 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1619497351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 SUDBURY CIR",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437149",
            "telephone_number": "630-362-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 SUDBURY CIR",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437149",
            "telephone_number": "630-362-5979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 E Roosevelt Rd",
            "address_purpose": "LOCATION",
            "city": "Villa Park",
            "state": "IL",
            "postal_code": "601813500",
            "country_code": "US",
            "telephone_number": "630-601-8625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "KATHLEEN",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-23",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "HI",
            "license": "BA-190",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-17-26160",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "152000275",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR ANALYST CERTIFICATION BOARD (BACB)",
            "identifier": "1-17-26160",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DCCA",
            "identifier": "BA-190",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDFPR",
            "identifier": "152000275",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; 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.