MEDICARE: JENNIFER LEE LINK BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-05-2315	MA

General Provider Information

NPI Number	:	1043511579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LEE LINK BCBA

Provider Business Mailing Address
First Line	:	733 HASTINGS DR
Second Line	:
City	:	BUFFALO GROVE
State	:	IL
Zip	:	60089-6906
Country	:	US
Telephone Number	:	224-676-0202
Fax Number	:	844-726-2721

Provider Business Practice Location Address
First Line	:	733 HASTINGS DR
Second Line	:
City	:	BUFFALO GROVE
State	:	IL
Zip	:	60089-6906
Country	:	US
Telephone Number	:	224-676-0202
Fax Number	:	844-726-2721

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2010
Last Update Date	:	01/14/2021

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