Jacqueline Ortiz Contreras
Individual provider Active NPI Behavior Technician · Genoa, IL
NPI 1720722754 · NPPES record last updated Apr 26, 2022
Key facts
- NPI
- 1720722754
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 41 Cedar LN
Genoa, IL 60135-1179 - Phone
- (815) 375-4739
- NPI assigned
- Apr 26, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
41 Cedar LN
Genoa, IL 60135-1179
Mailing address
41 Cedar LN
Genoa, IL 60135-1179
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | n/a | Other |
Other providers in Genoa, IL
- Lori Beth Bankson
- Ben Gordon Center
- Allison Marie Brown
- Kristin Brust
- Jeffrey T Caron
- David N McAuslan DDS PC
- Victoria Elizabeth Deku
- Steven J Disanti
- Dr Hilda Hattar DC PC
- Justin Tyler Durancik
All providers in Genoa, IL · Behavior Technician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.