Active NPI
Justin Reyes
- Behavior Technician
- Aurora, IL
National Provider Identifier
1821549171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-16-23908
- Practice address
- 452 N Eola Rd
Aurora, IL 60502-9612 - Phone
- (630) 999-0401
- Fax
- (630) 423-9669
- NPI assigned
- Oct 21, 2016
- Last updated
- Oct 21, 2016
- Sex
- Male
- Sole proprietor
- Yes
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-16-23908 | IL | Primary |
Addresses
Primary practice location
452 N Eola Rd
Aurora, IL 60502-9612
Mailing address
5338 N Latrobe Ave
Chicago, IL 60630-2206
Phone (773) 682-0140
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-16-23908 | IL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477008000000",
"number": "1821549171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5338 N LATROBE AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606302206",
"telephone_number": "773-682-0140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "452 N EOLA RD",
"city": "AURORA",
"state": "IL",
"postal_code": "605029612",
"telephone_number": "630-999-0401",
"fax_number": "630-423-9669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "JUSTIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-10-21",
"last_updated": "2016-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": "RBT-16-23908",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.