Individual provider Active NPI

Matthew Ryan Nordman

  • Behavior Analyst
  • Plainfield, IL
National Provider Identifier
1689044943
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
13550 S Route 30
Suite 204 # E
Plainfield, IL 60544
Phone
(815) 308-2322
Fax
(844) 991-3532
NPI assigned
Sep 30, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X IL Primary

Addresses

Primary practice location

13550 S Route 30
Suite 204 # E
Plainfield, IL 60544

Mailing address

13550 S Route 30
Suite 204 # E
Plainfield, IL 60544
Phone (815) 308-2322

Other practice location 1

24641 W Harvester Dr
Plainfield, IL 60544-4207
Phone (815) 713-9260

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

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Behavior Consulting LLC Behavior Analyst CurrentSince Mar 1, 2021 Accepting new patients

Locations

67 E Madison St
Ste 1603A
Chicago, IL 60603
Phone (773) 852-5894

13550 S Route 30
Ste 204E
Plainfield, IL 60544
Phone (815) 308-2322

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1689044943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13550 S ROUTE 30",
            "address_2": "SUITE 204 # E",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "60544",
            "telephone_number": "815-308-2322",
            "fax_number": "844-991-3532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13550 S ROUTE 30",
            "address_2": "SUITE 204 # E",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "60544",
            "telephone_number": "815-308-2322",
            "fax_number": "844-991-3532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24641 W Harvester Dr",
            "address_purpose": "LOCATION",
            "city": "Plainfield",
            "state": "IL",
            "postal_code": "605444207",
            "country_code": "US",
            "telephone_number": "815-713-9260",
            "fax_number": "844-991-3532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NORDMAN",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-30",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.