Taylor Danielle Willis, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

12042700 Issued in IL

Practice address

2544 E 91St St
Chicago, IL 60617-4010

Phone

(219) 688-1425

NPI assigned

Jul 1, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Taylored Innovations LLC

  • Behavior Analyst
  • Chicago, IL
  • NPI 1891628350
  NPD Authorized official
• Achievers ABA LLC

  • Community/Behavioral Health Agency
  • Indianapolis, IN
  • NPI 1366037053
  NPD (past)
• Attain ABA NE LLC

  • Behavior Analyst
  • Lakewood, NJ
  • NPI 1710535752
  NPD (past)

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1770145690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2544 E 91ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174010",
            "telephone_number": "219-688-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2544 E 91ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174010",
            "telephone_number": "219-688-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "TAYLOR",
        "middle_name": "DANIELLE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "12042700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20190701662505",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "dwillis@envisionunlimited.org",
            "affiliation": "Y",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8 South Michigan Avenue",
            "address_2": "Suite 1700",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606033353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lacanda Willis
• Michawn Willis, PHARM D
• Michelle L Willis, PA-C
• Payton Willis
• Stephanie Willis, LCPC, CADC
• Tiffany Willis
• Trichia Willis, OTR/L
• Victoria Willis
• Paula Willoughby Dejesus, DO
• Rebekah Leigh Willoughby, AUD

• Behavior Analyst in Chicago, IL
• Providers in Chicago, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.