Active NPI
Christine E Rudolph
- Behavior Analyst
- Skokie, IL
National Provider Identifier
1912530122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 2227285
- Practice address
- 5225 Old Orchard Rd Ste 17
Skokie, IL 60077-1027 - Phone
- (847) 271-6840
- NPI assigned
- Feb 16, 2020
- Last updated
- Feb 16, 2020
- 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 | 2227285 | IL | Primary |
Addresses
Primary practice location
5225 Old Orchard Rd Ste 17
Skokie, IL 60077-1027
Mailing address
547 Meadowview Dr
Wauconda, IL 60084-2382
Phone (847) 409-3864
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 |
|---|---|---|---|
| 2227285 | IL | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581811200000",
"number": "1912530122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "547 MEADOWVIEW DR",
"city": "WAUCONDA",
"state": "IL",
"postal_code": "600842382",
"telephone_number": "847-409-3864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5225 OLD ORCHARD RD STE 17",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600771027",
"telephone_number": "847-271-6840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDOLPH",
"first_name": "CHRISTINE",
"middle_name": "E",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-16",
"last_updated": "2020-02-16",
"certification_date": "2020-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IL",
"license": "2227285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Skokie, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.