Active NPI
Nicole Neagle
- Behavior Technician
- Elmhurst, IL
National Provider Identifier
1780240499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 19-86808
- Practice address
- 650 W Grand Ave Ste 207
Elmhurst, IL 60126-1025 - Phone
- (844) 263-1613
- Fax
- (844) 263-1612
- NPI assigned
- May 17, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 19-86808 | IL | Primary |
Addresses
Primary practice location
650 W Grand Ave Ste 207
Elmhurst, IL 60126-1025
Mailing address
650 W Grand Ave Ste 207
Elmhurst, IL 60126-1025
Phone (844) 263-1613
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19-86808 | IL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Total Spectrum, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Behavior Analyst
- Elmhurst, IL
- NPI 1922423177
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558051200000",
"number": "1780240499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 W GRAND AVE STE 207",
"city": "ELMHURST",
"state": "IL",
"postal_code": "601261025",
"telephone_number": "844-263-1613",
"fax_number": "844-263-1612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 W GRAND AVE STE 207",
"city": "ELMHURST",
"state": "IL",
"postal_code": "601261025",
"telephone_number": "844-263-1613",
"fax_number": "844-263-1612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEAGLE",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-17",
"last_updated": "2019-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": "19-86808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elmhurst, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.