ABA OF WISCONSIN, LLC (NPI# 1104209923) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104209923 |
| Entity Type | Organization |
| Organization Name | ABA OF WISCONSIN, LLC |
| Practice Address |
1501 Dogwood Dr Woodridge IL 60517-4649 |
| Practice Telephone | 7156002211 |
| Practice Fax Number | 6303959198 |
| Mailing Telephone | 7156002211 |
| Mailing Fax Number | 6303959198 |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2016-01-26 |
| Authorized Official Name | ERIN RABER (PROGRAM MANAGER) |
| Authorized Official Telephone | 7156002211 |
| Is Organization Subpart | Y |
| Parent Organization Name | ABA OF ILLINOIS, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
1501 DOGWOOD DR |
| City | WOODRIDGE |
| State | IL |
| Zip Code | 60517-4649 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093006546 | Nicole Berlowski | Rehabilitation Practitioner | 1501 Dogwood Dr, Woodridge, IL 60517-4649 | 2011-05-02 |
| 1346864469 | Alexa Ramirez | Behavioral Analyst | 1501 Dogwood Dr, Woodridge, IL 60517-4649 | 2020-06-04 |
| 1720559347 | Miranda May Olsen | Behavioral Analyst | 1501 Dogwood Dr, Woodridge, IL 60517-4649 | 2018-12-07 |
| 1154804441 | Deborah Ann Blake | Behavioral Analyst | 1501 Dogwood Dr, Woodridge, IL 60517-4649 | 2018-09-12 |
| 1245718121 | Katelyn Emily Wurtz | Behavioral Analyst | 1501 Dogwood Dr, Woodridge, IL 60517 | 2018-08-01 |
| 1639684392 | Alyssa Espinoza | Behavioral Analyst | 1501 Dogwood Dr, Woodridge, IL 60517-4649 | 2017-12-04 |
| 1265970453 | Joseph Werderitch | Behavior Technician | 1501 Dogwood Dr, Woodridge, IL 60517-4649 | 2017-02-07 |
| 1467995407 | Brian Gall | Behavioral Analyst | 1501 Dogwood Dr, Woodridge, IL 60517-4649 | 2016-11-23 |
| 1538611561 | Evelyn Amaro | Behavioral Analyst | 1501 Dogwood Dr, Woodridge, IL 60517-4649 | 2016-10-25 |
| 1255676532 | Chelsea Skinner | Behavioral Analyst | 1501 Dogwood Dr, Woodridge, IL 60517-4649 | 2012-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265085401 | Sana Saqlain | Pharmacist | 10204 Werch Dr, Ste 302, Woodridge, IL 60517 | 2019-07-17 |
| 1326529421 | Allison Ann Chavez | Counselor | 6912 Young Ct, Woodridge, IL 60517 | 2018-08-27 |
| 1245768274 | Monika Maria Waclaw | Dentist | 6440 Main St Ste 310, Woodridge, IL 60517 | 2017-06-04 |
| 1003278946 | Beverly Ehlebracht | Physical Therapy Assistant | 7409 Woodrige Dr, Suite F, Woodrige, IL 60517 | 2016-03-21 |
| 1831597194 | Advanced Wellness Medical, LLC | General Practice | 6325 Main Street, Suite 120, Woodridge, IL 60517 | 2014-12-18 |
| 1538576608 | Northwest Home Care, Inc. | Home Health | 1999 75th Street, Suite 201, Woodridge, IL 60517 | 2014-07-21 |
| 1689956591 | Latha Boyd | Pharmacist | 2501 W 75th St, Woodridge, IL 60517 | 2011-09-16 |
| 1437431798 | Timothy J Madiar | Pharmacist | 2501 West 75th Street, Woodridge, IL 60517 | 2011-09-13 |
| 1720368426 | Matthew Scalzitti | Pharmacist | 7215 Janes Ave. #300, Woodridge, IL 60517 | 2011-08-25 |
| 1538454558 | Karen Hokanson | Pharmacist | 2333 W 63rd St, Woodridge, IL 60517 | 2011-06-17 |
| Find all providers in zip 60517 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033651567 | Holly Marie Diaz | Community/Behavioral Health | 8103 Route 53, Unit 9, Woodridge, IL 60517-3652 | 2016-11-15 |
| 1689995029 | Metropolitan Family Services | Community/Behavioral Health | 1999 75th St, Suite 102, Woodridge, IL 60517-2664 | 2010-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820648 | Community Wellness Group | Community/Behavioral Health | 635 Argyle Ave, Flossmoor, IL 60422-1201 | 2020-10-26 |
| 1437758711 | Gina Baldacci, Lcsw, LLC | Community/Behavioral Health | 231 Longridge Dr, Bloomingdale, IL 60108 | 2020-10-19 |
| 1790383610 | Joni Lamb Therapy, LLC | Community/Behavioral Health | 1555 Sherman Ave # 308, Evanston, IL 60201-4421 | 2020-10-13 |
| 1811594906 | Everyday Empowered Clinical Services, Ltd. | Community/Behavioral Health | 5117 Main St, Suite #7, Downers Grove, IL 60515 | 2020-10-02 |
| 1942817150 | Pacem Wellness, LLC | Community/Behavioral Health | 8 Eagle Ctr Ste 12, O Fallon, IL 62269-1947 | 2020-09-30 |
| 1831703271 | Boules Clinical Psychology Group | Community/Behavioral Health | 200 S Frontage Rd Ste 324, Burr Ridge, IL 60527-6953 | 2020-09-02 |
| 1336753896 | Counseling Kennedy Shenberg | Community/Behavioral Health | 5752 N Campbell Ave Apt 1, Chicago, IL 60659-5080 | 2020-09-02 |
| 1265045371 | Brightside Recovery | Community/Behavioral Health | 1667 Belvidere Rd, Belvidere, IL 61008-9306 | 2020-08-28 |
| 1902419021 | Brightside Recovery | Community/Behavioral Health | 8041 186th St Ste B, Tinley Park, IL 60487-9344 | 2020-08-28 |
| 1700498573 | Bobby E. Wright Comprehensive Behavioral Health Center, Inc. | Community/Behavioral Health | 5816 W Division St Fl 1, Chicago, IL 60651-1003 | 2020-08-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.