Active NPI
Maribel Rose Rodriguez
- Behavior Analyst
- Des Plaines, IL
National Provider Identifier
1730822040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- R362-5560-1860
- Practice address
- 1779 S Cora St
Des Plaines, IL 60018-2211 - Phone
- (224) 535-0365
- NPI assigned
- Apr 14, 2022
- Last updated
- Apr 14, 2022
- Sex
- Female
- Sole proprietor
- No
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 Analyst | 103K00000X | R362-5560-1860 | IL | Primary |
Addresses
Primary practice location
1779 S Cora St
Des Plaines, IL 60018-2211
Mailing address
1779 S Cora St
Des Plaines, IL 60018-2211
Phone (224) 535-0365
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 |
|---|---|---|---|
| R362-5560-1860 | IL | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649894400000",
"number": "1730822040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1779 S CORA ST",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600182211",
"telephone_number": "224-535-0365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1779 S CORA ST",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600182211",
"telephone_number": "224-535-0365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "MARIBEL",
"middle_name": "ROSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-14",
"last_updated": "2022-04-14",
"certification_date": "2022-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IL",
"license": "R362-5560-1860",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Plaines, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.