Mebe Illinois

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

MEBE ILLINOIS

Practice address

825 S Waukegan Rd Ste A8
Lake Forest, IL 60045-2665

Phone

(619) 795-9925

NPI assigned

Oct 15, 2020

Organization subpart

No

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

Authorized official

Name

Esteban Gonzalez

Title

Contracting and Credentialing Spec

Phone

(619) 323-0832

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1801494364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8885 RIO SAN DIEGO DR STE 340",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081669",
            "telephone_number": "619-795-9925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 S WAUKEGAN RD STE A8",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600452665",
            "telephone_number": "619-795-9925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEBE ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ESTEBAN",
        "authorized_official_title_or_position": "CONTRACTING AND CREDENTIALING SPEC",
        "authorized_official_telephone_number": "619-323-0832"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Joseph McGillen, M.D.
• Cara McGowan, MA, LPC
• Caleen K McGrath, LCSW
• Michael S McGuire, MD
• Andrew McGurn, MD
• Sharon Lynn Meekma, MS OTR/L
• Leslie Ann Mei, PA-C
• Melissa Carava, LLC
• Laura Ann Meller, MS, APN, CNS-BC
• Heidi Christine Memmel Mitidiero, MD

• Behavior Analyst in Lake Forest, IL
• Providers in Lake Forest, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; 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.