Active NPI
Mary Waterman, BCBA
- Behavior Analyst
- Wheaton, IL
National Provider Identifier
1982070736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-15-18331
- Practice address
- 219 S Chase St
Wheaton, IL 60187-5544 - Phone
- (630) 715-1513
- NPI assigned
- Aug 17, 2015
- 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 | 1-15-18331 | IL | Primary |
Addresses
Primary practice location
219 S Chase St
Wheaton, IL 60187-5544
Mailing address
219 S Chase St
Wheaton, IL 60187-5544
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439769600000",
"number": "1982070736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "219 S CHASE ST",
"city": "WHEATON",
"state": "IL",
"postal_code": "601875544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "219 S CHASE ST",
"city": "WHEATON",
"state": "IL",
"postal_code": "601875544",
"telephone_number": "630-715-1513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERMAN",
"first_name": "MARY",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-17",
"last_updated": "2015-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IL",
"license": "1-15-18331",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wheaton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.