Active NPI
Mary-Claire Cathleen Dimiceli, M.S., BCBA
- Behavior Analyst
- Wilmette, IL
National Provider Identifier
1881835098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-08-4869
- Practice address
- 424 Pine Manor Dr
Wilmette, IL 60091-2364 - Phone
- (917) 324-2933
- NPI assigned
- Mar 18, 2009
- Last updated
- Sep 2, 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 | 1-08-4869 | IL | Primary |
Addresses
Primary practice location
424 Pine Manor Dr
Wilmette, IL 60091-2364
Mailing address
424 Pine Manor Dr
Wilmette, IL 60091-2364
Phone (917) 324-2933
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630540800000",
"number": "1881835098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "424 PINE MANOR DR",
"city": "WILMETTE",
"state": "IL",
"postal_code": "600912364",
"telephone_number": "917-324-2933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 PINE MANOR DR",
"city": "WILMETTE",
"state": "IL",
"postal_code": "600912364",
"telephone_number": "917-324-2933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMICELI",
"first_name": "MARY-CLAIRE",
"middle_name": "CATHLEEN",
"name_prefix": "Mrs.",
"credential": "M.S., BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-18",
"last_updated": "2021-09-02",
"certification_date": "2021-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IL",
"license": "1-08-4869",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmette, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.