ABA Revolution LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

ABA REVOLUTION LLC

Practice address

1326 Edgewood LN
Northbrook, IL 60062-4716

Phone

(224) 241-1784

NPI assigned

Feb 24, 2025

Organization subpart

No

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

Authorized official

Name

Daniel Blank

Title

Ceo

Phone

(224) 241-1784

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1720884331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 EDGEWOOD LN",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624716",
            "telephone_number": "224-241-1784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1326 EDGEWOOD LN",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624716",
            "telephone_number": "224-241-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABA REVOLUTION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "BLANK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "224-241-1784"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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