Active NPI
Veronica Martinez
- Behavior Analyst
- Worth, IL
National Provider Identifier
1831783380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 374376
- Practice address
- 11301 S Harlem Ave
Worth, IL 60482-2001 - Phone
- (708) 586-2604
- NPI assigned
- Feb 25, 2021
- Last updated
- Feb 25, 2021
- 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 Analyst | 103K00000X | 374376 | IL | Primary |
Addresses
Primary practice location
11301 S Harlem Ave
Worth, IL 60482-2001
Mailing address
3552 S Ashland Ave
Chicago, IL 60609-1317
Phone (773) 543-3828
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 |
|---|---|---|---|
| 374376 | IL | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Asd Life Inc. | Current | Accepting new patients | |
| Autism Behavior Therapy | Behavior Analyst | Past | Accepting new patients |
Locations
11301 S Harlem Ave
Worth, IL 60482
Phone (708) 586-2604
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614211200000",
"number": "1831783380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3552 S ASHLAND AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606091317",
"telephone_number": "773-543-3828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11301 S HARLEM AVE",
"city": "WORTH",
"state": "IL",
"postal_code": "604822001",
"telephone_number": "708-586-2604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "VERONICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-25",
"last_updated": "2021-02-25",
"certification_date": "2021-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IL",
"license": "374376",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worth, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.