Miranda Renee Illius, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-18-30479 Issued in OH

Practice address

38530 Chester Rd Ste 100
Avon, OH 44011-4048

Phone

(216) 282-1234

NPI assigned

Jun 26, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1760977342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27991 CENTER RIDGE RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441453902",
            "telephone_number": "440-455-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38530 CHESTER RD STE 100",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440114048",
            "telephone_number": "216-282-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILLIUS",
        "first_name": "MIRANDA",
        "middle_name": "RENEE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OH",
            "license": "1-18-30479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittani Houpt
• Jacob Max Huddleston
• Hedwig Huebler
• Thomas Robert Hughes, D,D,S,
• John H Hwang, O.D.
• Esme Susanne Irvine, DO
• Wahib E Isac, MD
• Erin Nicole Isenberg
• Jacobs Eye Center, LTD.
• Bethany Marie Jacobs, CCC-SLP

• Behavior Analyst in Avon, OH
• Providers in Avon, OH by specialty
• Behavior Analyst in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.

Verify at the official NPI Registry.