Taylor Carrasco, BCBA
Individual provider Active NPI Behavior Analyst · Wood Dale, IL
NPI 1649942277 · NPPES record last updated Aug 27, 2024
Key facts
- NPI
- 1649942277
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- Practice address
- 220 Gerry Dr
Wood Dale, IL 60191-1129 - Phone
- (847) 553-4009
- Fax
- (847) 498-5438
- NPI assigned
- Oct 1, 2021
- Reactivated
- Jul 25, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KGH Consultation & Treatment, Inc. | Behavior Analyst | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Yes |
Addresses
Primary practice location
220 Gerry Dr
Wood Dale, IL 60191-1129
Mailing address
220 Gerry Dr
Wood Dale, IL 60191-1129
Phone (847) 553-4009
Other providers in Wood Dale, IL
- Judith M. Bobus
- Dorothy Maria Bondarowicz
- Boris Kaltchev DMD, P.C.
- Jessica Suzanne Brock
- Nancy J Cannon
- Center for Family Health Care, S.C.
- Bristena Olivia Chelariu
- Child'S Voice School
- Christopher I Szpila D C PC
- Constantina N. Kass, LLC
All providers in Wood Dale, IL · Behavior Analyst in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.