Individual provider Active NPI

Vesta Samuolis

  • Behavior Technician
  • Burr Ridge, IL
National Provider Identifier
1700752631
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
106S00000X Issued in IL
Practice address
7914 Buck TRL
Burr Ridge, IL 60527-5115
Phone
(630) 880-6258
Fax
(630) 880-6258
NPI assigned
Oct 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 106S00000X IL Primary

Addresses

Primary practice location

7914 Buck TRL
Burr Ridge, IL 60527-5115

Mailing address

7914 Buck TRL
Burr Ridge, IL 60527-5115
Phone (630) 880-6258

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

LicenseStateTypeSpecialty
106S00000XILMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1760572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1700752631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7914 BUCK TRL",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275115",
            "telephone_number": "630-880-6258",
            "fax_number": "630-880-6258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7914 BUCK TRL",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275115",
            "telephone_number": "630-880-6258",
            "fax_number": "630-880-6258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUOLIS",
        "first_name": "VESTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-16",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "106S00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burr Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; 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.