Individual provider Active NPI

Vanessa Radosza, RBT-18-51940

  • Behavior Technician
  • Bloomingdale, IL
National Provider Identifier
1912402835
Registry record updated Mar 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
18-51940 Issued in IL
Practice address
333 Byron Ave
Bloomingdale, IL 60108-1807
Phone
(630) 677-9277
NPI assigned
Mar 25, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 18-51940
Behavior Technician 106S00000X 18-51940 IL Primary

Addresses

Primary practice location

333 Byron Ave
Bloomingdale, IL 60108-1807

Mailing address

333 Byron Ave
Bloomingdale, IL 60108-1807

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

LicenseStateTypeSpecialty
18-51940ILMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1521936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521936000000",
    "number": "1912402835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 BYRON AVE",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 BYRON AVE",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081807",
            "telephone_number": "630-677-9277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADOSZA",
        "first_name": "VANESSA",
        "credential": "RBT-18-51940",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-25",
        "last_updated": "2018-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": "18-51940",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "18-51940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2018; 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.