Active NPI
Ksenia Golikova
- Behavior Technician
- Lincolnwood, IL
National Provider Identifier
1790285872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB384999
- Practice address
- 4433 W Touhy Ave Ste 335
Lincolnwood, IL 60712-1820 - Phone
- (877) 486-4140
- NPI assigned
- Feb 15, 2018
- 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 | BACB384999 | IL | Primary |
Addresses
Primary practice location
4433 W Touhy Ave Ste 335
Lincolnwood, IL 60712-1820
Mailing address
950 Lee St Ste 210
Des Plaines, IL 60016-6574
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 |
|---|---|---|---|
| BACB384999 | IL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore Pediatric Therapy | 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.
-
- Pediatric Occupational Therapist
- Glenview, IL
- NPI 1811909492
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518652800000",
"number": "1790285872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 LEE ST STE 210",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600166574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4433 W TOUHY AVE STE 335",
"city": "LINCOLNWOOD",
"state": "IL",
"postal_code": "607121820",
"telephone_number": "877-486-4140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLIKOVA",
"first_name": "KSENIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-15",
"last_updated": "2018-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": "BACB384999",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincolnwood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.