Individual provider Active NPI

Andrea Marie Rau, BCBA

  • Behavior Analyst
  • New Lenox, IL
National Provider Identifier
1760620710
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
R000067585732 Issued in MI
Practice address
1200 S Cedar Rd
New Lenox, IL 60451-2678
Phone
(815) 485-4781
Fax
(815) 485-9145
NPI assigned
Jan 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X R000067585732 MI Primary

Addresses

Primary practice location

1200 S Cedar Rd
New Lenox, IL 60451-2678

Mailing address

1200 S Cedar Rd
New Lenox, IL 60451-2678
Phone (815) 485-4781

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

LicenseStateTypeSpecialty
R000067585732MIMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1760620710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S CEDAR RD",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604512678",
            "telephone_number": "815-485-4781",
            "fax_number": "815-485-9145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S CEDAR RD",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604512678",
            "telephone_number": "815-485-4781",
            "fax_number": "815-485-9145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAU",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-29",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "R000067585732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; 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.