Nicolette Paige Susralski, MA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-25-81898 Issued in IL

Practice address

16086 Harlem Ave
Tinley Park, IL 60477-1612

Phone

(815) 469-1500

NPI assigned

May 7, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Westside Childrens Therapy

  • Physical Therapist
  • Joliet, IL
  • NPI 1972783900
  NPD (past)

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

{
    "created_epoch": "1715040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1821846874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16086 HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771612",
            "telephone_number": "708-719-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16086 HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771612",
            "telephone_number": "815-469-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSRALSKI",
        "first_name": "NICOLETTE",
        "middle_name": "PAIGE",
        "name_prefix": "Ms.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-07",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "RBT-22-203206",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-25-81898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunflower Patterson Inc NFP
• Sunrise Medical Center S. C.
• Supercare LLC
• Supreme Physical Therapy Co.
• Surgical Care Associates LTD
• Yogesh G Sutrave, RSA
• Terese Sweeney, RDN, LDN, CEDS-C
• Sweet Dreams Infant Care
• Dawn B Swenson, DDS
• Sandy Sybert, LCPC

• Behavior Analyst in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; 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.