NPIMap

Organization Active NPI

Lifespeed, LLC

  • Behavior Analyst
  • Evanston, IL
National Provider Identifier
1851783013
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
LIFESPEED, LLC
Practice address
820 Davis St
Suite 455
Evanston, IL 60201-4431
Phone
(312) 404-7225
NPI assigned
Feb 25, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Authorized official

Name
Anthony Russo
Title
Ma, Bcba
Phone
(312) 404-7225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

820 Davis St
Suite 455
Evanston, IL 60201-4431

Mailing address

820 Davis St
Suite 455
Evanston, IL 60201-4431

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424822400000",
    "number": "1851783013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 DAVIS ST",
            "address_2": "SUITE 455",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 DAVIS ST",
            "address_2": "SUITE 455",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014431",
            "telephone_number": "312-404-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPEED, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-25",
        "last_updated": "2015-02-25",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "MA, BCBA",
        "authorized_official_telephone_number": "312-404-7225"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; 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.