Active NPI
Kristin C Greenwood, BCBA
- Behavior Analyst
- Countryside, IL
National Provider Identifier
1669763512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1084881
- Practice address
- 9649 W 55TH St
Countryside, IL 60525-3632 - Phone
- (708) 352-3580
- NPI assigned
- Apr 27, 2011
- Last updated
- Apr 27, 2011
- 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 Analyst | 103K00000X | 1084881 | NU | Primary |
Addresses
Primary practice location
9649 W 55TH St
Countryside, IL 60525-3632
Mailing address
612 S Harvey Ave
Apt 1-N
Oak Park, IL 60304-1517
Phone (412) 216-3450
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": "1303862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303862400000",
"number": "1669763512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "612 S HARVEY AVE",
"address_2": "APT 1-N",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603041517",
"telephone_number": "412-216-3450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9649 W 55TH ST",
"city": "COUNTRYSIDE",
"state": "IL",
"postal_code": "605253632",
"telephone_number": "708-352-3580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENWOOD",
"first_name": "KRISTIN",
"middle_name": "C",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-27",
"last_updated": "2011-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NU",
"license": "1084881",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Countryside, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.