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NPI Code Detail

MEDICARE: VERONICA GLICKMAN M.A., M.S., BCBA

MEDICARE: VERONICA GLICKMAN M.A., M.S., 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
1103K00000XBehavior Analyst1-14-15504

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11-14-15504OTHERBACB

General Provider Information

NPI Number : 1174941603
Entity Type Code : Individual
Provider Name (Legal Business Name) : VERONICA GLICKMAN M.A., M.S., BCBA
Provider Business Mailing Address
First Line : 1250 EXECUTIVE PL STE 201
Second Line :
City : GENEVA
State : IL
Zip : 60134-3805
Country : US
Telephone Number : 815-223-2237
Fax Number : 815-327-3440
Provider Business Practice Location Address
First Line : 1250 EXECUTIVE PL STE 201
Second Line :
City : GENEVA
State : IL
Zip : 60134-3805
Country : US
Telephone Number : 815-223-2237
Fax Number : 815-327-3440
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2014
Last Update Date : 02/23/2022

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