JESSICA KUBACKI (NPI# 1528574472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528574472 |
| Entity Type | Individual |
| Full Name | JESSICA KUBACKI |
| Other Name | JESSICA GONZALEZ |
| Practice Address |
535 Hinman Ave Apt F3 Evanston IL 60202 |
| Mailing Address |
535 Hinman Ave Apt F3 Evanston IL 60202-3058 |
| Practice Telephone | 2247309286 |
| Mailing Telephone | 2247309286 |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2019-01-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1409 W Carroll Ave, Chicago, IL 60607 | 3127330883 |
| Street Address |
535 HINMAN AVE APT F3 |
| City | EVANSTON |
| State | IL |
| Zip Code | 60202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548889496 | Ktsmiles, Inc | Clinic/Center | 2408 Main Street, Evanston, IL 60202 | 2020-04-10 |
| 1831751163 | Dorcas Matowe | Marriage & Family Therapist | The Family Institute, 618 Library Place, Evanston, IL 60202 | 2019-07-08 |
| 1457847170 | Lilah Handler | Social Worker | 905 Forest Ave, Apt 1, Evanston, IL 60202 | 2018-07-05 |
| 1376075853 | Lisa Meyerson Acupuncture | Acupuncturist | 1234 Sherman Avenue, Lighthouse Yoga and Acupuncture, Evanston, IL 60202 | 2017-04-03 |
| 1427597368 | Lillian Obucina Dds PC | Dentist | 111 North Wabash, Suite 1522, Chicago, IL 60202 | 2017-02-13 |
| 1184176893 | Amelia Willcox | Speech-Language Pathologist | 620 Sheridan Square, Apartment 1, Evanston, IL 60202 | 2016-10-28 |
| 1831547785 | Thomas Hagerty Jr. | Pharmacist | 2491 W Howard St, Evanston, IL 60202 | 2016-06-01 |
| 1013361948 | Autism Hope Support | In Home Supportive Care | 815 Seward Apt. 1s, Evanston, IL 60202 | 2016-04-18 |
| 1215302625 | Preferred Dentistry Associates, LLC | Dentist | 1029 Howard Street, Evanston, IL 60202 | 2015-12-10 |
| 1407237134 | Dillon James Barron | Emergency Medicine | Presence St Francis, 355 Ridge Avenue, Evanston, IL 60202 | 2015-06-18 |
| Find all providers in zip 60202 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528609609 | Treana Monroe | Developmental Therapist | 619 Brummel St Apt 22, Evanston, IL 60202-3548 | 2019-09-30 |
| 1124479407 | Ana Leffel | Developmental Therapist | 826 Michigan Ave, 1a, Evanston, IL 60202-4415 | 2016-06-28 |
| 1588038699 | Robin Lynn Dodds | Developmental Therapist | Center for Audiology Speech Language And, Northwestern University 2315 Campus Drive, Evanston, IL 60208-0001 | 2015-12-01 |
| 1659662336 | Kristen Marie Schraml | Developmental Therapist | 1621 Wesley Ave, Evanston, IL 60201-4105 | 2011-04-28 |
| 1295057156 | Daleisha Owolide | Developmental Therapist | 325 Darrow Ave, Evanston, IL 60202-3246 | 2010-02-19 |
| 1710210356 | Candace Francene Austin | Developmental Therapist | 724 Dodge Ave, Evanston, IL 60202-1965 | 2009-09-15 |
| 1033340815 | Katherine A Simon | Developmental Therapist | 1321 Oak Ave, Apt 3a, Evanston, IL 60201-4240 | 2009-07-28 |
| 1619104791 | Deborah Hirshfield | Developmental Therapist | 2002 Harrison St, Evanston, IL 60201-5845 | 2009-06-16 |
| 1689825721 | Kathryn B Murray | Developmental Therapist | 536 1/2 Michigan Ave, Unit D1, Evanston, IL 60202-3035 | 2008-10-07 |
| 1902078777 | Susan C Cox | Developmental Therapist | 2723 Thayer St, Evanston, IL 60201-1344 | 2008-04-01 |
| Find all providers in EVANSTON | ||||
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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.