Active NPI
Abdul Rahman Radwan
- Behavior Technician
- Lombard, IL
National Provider Identifier
1780414268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-294321
- Practice address
- 44 W Roosevelt Rd
Lombard, IL 60148-4402 - Phone
- (312) 619-0221
- NPI assigned
- Aug 7, 2024
- Last updated
- Aug 7, 2024
- Sex
- Male
- 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 | RBT-23-294321 | IL | Primary |
Addresses
Primary practice location
44 W Roosevelt Rd
Lombard, IL 60148-4402
Mailing address
6340 Americana Dr Apt 601
Willowbrook, IL 60527-2246
Phone (312) 619-0221
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 |
|---|---|---|---|
| RBT-23-294321 | IL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722988800000",
"number": "1780414268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6340 AMERICANA DR APT 601",
"city": "WILLOWBROOK",
"state": "IL",
"postal_code": "605272246",
"telephone_number": "312-619-0221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 W ROOSEVELT RD",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601484402",
"telephone_number": "312-619-0221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADWAN",
"first_name": "ABDUL RAHMAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-07",
"last_updated": "2024-08-07",
"certification_date": "2024-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": "RBT-23-294321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lombard, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.