Healthcare Provider Details

I. General information

NPI: 1396681821
Provider Name (Legal Business Name): FARZANA DAWOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 W ARMY TRAIL RD STE 100
ADDISON IL
60101-1478
US

IV. Provider business mailing address

800 ENTERPRISE DR STE 214
OAK BROOK IL
60523-4218
US

V. Phone/Fax

Practice location:
  • Phone: 312-600-5061
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-387386
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: