Active NPI
Scott Brandon Chan
- Behavior Technician
- Des Plaines, IL
National Provider Identifier
1891378709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-21-165066
- Practice address
- 950 Lee St Ste 210
Des Plaines, IL 60016-6574 - Phone
- (866) 815-6592
- NPI assigned
- Apr 29, 2021
- 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-21-165066 | IL | Primary |
Addresses
Primary practice location
950 Lee St Ste 210
Des Plaines, IL 60016-6574
Mailing address
950 Lee St Ste 210
Des Plaines, IL 60016-6574
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-21-165066 | IL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619654400000",
"number": "1891378709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 LEE ST STE 210",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600166574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 LEE ST STE 210",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600166574",
"telephone_number": "866-815-6592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "SCOTT",
"middle_name": "BRANDON",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-04-29",
"last_updated": "2021-04-29",
"certification_date": "2021-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": "IL",
"license": "RBT-21-165066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Plaines, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.