Active NPI
Kelli Sander, RBT-18-71726
- Behavior Technician
- Medinah, IL
National Provider Identifier
1992269856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-18-71726
- Practice address
- 6N200 Medinah Rd
Medinah, IL 60157-9743 - Phone
- (847) 525-4999
- NPI assigned
- Jan 24, 2019
- Sex
- Female
- 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-18-71726 | IL | Primary |
Addresses
Primary practice location
6N200 Medinah Rd
Medinah, IL 60157-9743
Mailing address
6N200 Medinah Rd
Medinah, IL 60157-9743
Phone (847) 525-4999
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-18-71726 | IL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548288000000",
"number": "1992269856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6N200 MEDINAH RD",
"city": "MEDINAH",
"state": "IL",
"postal_code": "601579743",
"telephone_number": "847-525-4999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6N200 MEDINAH RD",
"city": "MEDINAH",
"state": "IL",
"postal_code": "601579743",
"telephone_number": "847-525-4999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDER",
"first_name": "KELLI",
"name_prefix": "Ms.",
"credential": "RBT-18-71726",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-24",
"last_updated": "2019-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": "RBT-18-71726",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medinah, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.