Active NPI
Fama Bamba
- Behavior Technician
- Deerfield, IL
National Provider Identifier
1649950817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 707 Lake Cook Rd Ste 312
Deerfield, IL 60015-4933 - Phone
- (877) 486-4140
- NPI assigned
- Jul 21, 2023
- Last updated
- Jul 21, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
707 Lake Cook Rd Ste 312
Deerfield, IL 60015-4933
Mailing address
206 N Green Bay Rd Apt 401
Waukegan, IL 60085-4482
Phone (224) 408-3507
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": "1689897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689897600000",
"number": "1649950817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 N GREEN BAY RD APT 401",
"city": "WAUKEGAN",
"state": "IL",
"postal_code": "600854482",
"telephone_number": "224-408-3507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 LAKE COOK RD STE 312",
"city": "DEERFIELD",
"state": "IL",
"postal_code": "600154933",
"telephone_number": "877-486-4140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAMBA",
"first_name": "FAMA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-21",
"last_updated": "2023-07-21",
"certification_date": "2023-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deerfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.