Individual provider Active NPI

Matthew Western

  • Behavior Technician
  • Chicago, IL
National Provider Identifier
1760003933
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
5500 S Shore Dr Apt 309
Chicago, IL 60637-5002
Phone
(734) 834-2221
NPI assigned
Apr 29, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X Primary

Addresses

Primary practice location

5500 S Shore Dr Apt 309
Chicago, IL 60637-5002

Mailing address

5500 S Shore Dr Apt 309
Chicago, IL 60637-5002
Phone (734) 834-2221

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Chicago

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

NPI Registry JSON

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1760003933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 S SHORE DR APT 309",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606375002",
            "telephone_number": "734-834-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 S SHORE DR APT 309",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606375002",
            "telephone_number": "734-834-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTERN",
        "first_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-29",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Chicago",
            "affiliation": "N",
            "address_1": "5500 S Shore Dr Apt 309",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606375002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; 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.