Active NPI
Lisa Brook Fowler-Kobylewski, RBT # 18-48630
- Behavior Technician
- Mokena, IL
National Provider Identifier
1689163347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 18-48630
- Practice address
- 9500 Bormet Dr Ste 201
Mokena, IL 60448-8399 - Phone
- (815) 469-1500
- NPI assigned
- May 8, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 18-48630 | IL | Primary |
Addresses
Primary practice location
9500 Bormet Dr Ste 201
Mokena, IL 60448-8399
Mailing address
7596 Denrick Rd
Cherry Valley, IL 61016-9708
Phone (815) 914-8215
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18-48630 | IL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657756800000",
"number": "1689163347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7596 DENRICK RD",
"city": "CHERRY VALLEY",
"state": "IL",
"postal_code": "610169708",
"telephone_number": "815-914-8215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9500 BORMET DR STE 201",
"city": "MOKENA",
"state": "IL",
"postal_code": "604488399",
"telephone_number": "815-469-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOWLER-KOBYLEWSKI",
"first_name": "LISA",
"middle_name": "BROOK",
"name_prefix": "Mrs.",
"credential": "RBT # 18-48630",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-08",
"last_updated": "2022-07-14",
"certification_date": "2022-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": "18-48630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mokena, IL
- Mahogony Briana Floyd, RBT
- Margaret Fontana
- Janet G Foote, APN-C
- Forefront Adult & Pediatric Care, S.C.
- Megan Therese Forsythe, COTA/L
- Debra Ann Fox, MA
- Frankfort Chiropractic Clinic
- Frankfort Chiropractic Clinic, P.C.
- Frankfort Spinal Rehabilitation & Physical Therapy Inc
- Lindsie Fransen, MSN, FNP-BC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.