Melissa R Brousil, BA, MAOL
Individual provider Active NPI Behavior Analyst · Blue Island, IL
NPI 1760617062 · NPPES record last updated Jan 17, 2019
Key facts
- NPI
- 1760617062
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- Practice address
- 2445 Birdsall St
Apt# 5
Blue Island, IL 60406-1748 - Phone
- (708) 212-0300
- NPI assigned
- May 16, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Arts
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Yes |
Addresses
Primary practice location
2445 Birdsall St
Apt# 5
Blue Island, IL 60406-1748
Mailing address
17390 Ottawa Ave
Tinley Park, IL 60477-3235
Phone (708) 212-0300
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- Rita Brongiel
- Gina Brown
- Frank M Bucki Jr.
- Darlene Jo Buis
- Jeffrey Bzdusek
- Marina Cajas
All providers in Blue Island, IL · Behavior Analyst in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2019. 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.