Individual provider Active NPI

Juliete Marie Reyes, M.S., BCBA

  • Behavior Analyst
  • Waukegan, IL
National Provider Identifier
1780457739
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
12368947 Issued in IL
Practice address
2749 Grand Ave
Waukegan, IL 60085-2406
Phone
(224) 436-0788
NPI assigned
Nov 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 12368947 IL Primary

Addresses

Primary practice location

2749 Grand Ave
Waukegan, IL 60085-2406

Mailing address

2625 N Clark St Apt 1503
Chicago, IL 60614-1860
Phone (773) 934-8261

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
12368947ILMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
The Place for Speech Therapy LLC Past Accepting new patients
Djje Holdings LLC Behavior Analyst Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1698796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1780457739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 N CLARK ST APT 1503",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141860",
            "telephone_number": "773-934-8261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2749 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852406",
            "telephone_number": "224-436-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "JULIETE",
        "middle_name": "MARIE",
        "credential": "M.S., BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-01",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "12368947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

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