Individual provider Active NPI

Alexis Kissane, RBT-18-47109

  • Behavior Technician
  • Geneva, IL
National Provider Identifier
1780176016
Registry record updated Jun 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-18-47109 Issued in IL
Practice address
1527 Kirkwood Dr
Geneva, IL 60134-1659
Phone
(847) 337-4981
NPI assigned
Jun 1, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-18-47109 IL Primary

Addresses

Primary practice location

1527 Kirkwood Dr
Geneva, IL 60134-1659

Mailing address

1527 Kirkwood Dr
Geneva, IL 60134-1659
Phone (847) 337-4981

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
RBT-18-47109ILMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1780176016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 KIRKWOOD DR",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601341659",
            "telephone_number": "847-337-4981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1527 KIRKWOOD DR",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601341659",
            "telephone_number": "847-337-4981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSANE",
        "first_name": "ALEXIS",
        "credential": "RBT-18-47109",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-01",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "RBT-18-47109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2018; 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.