Individual provider Active NPI

Ilhan Hassan Abdulle

  • Behavior Technician
  • Crystal, MN
National Provider Identifier
1639066483
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
5701 Kentucky Ave N Ste 209
Crystal, MN 55428-3386
Phone
(612) 386-7144
NPI assigned
Jun 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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 Primary

Addresses

Primary practice location

5701 Kentucky Ave N Ste 209
Crystal, MN 55428-3386

Mailing address

1821 University Ave W Ste 223
Saint Paul, MN 55104-2801
Phone (612) 386-7144

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

NPI Registry JSON

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

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1639066483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 UNIVERSITY AVE W STE 223",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042801",
            "telephone_number": "612-386-7144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 KENTUCKY AVE N STE 209",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554283386",
            "telephone_number": "612-386-7144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDULLE",
        "first_name": "ILHAN",
        "middle_name": "HASSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.