Healthcare Provider Details

I. General information

NPI: 1790665420
Provider Name (Legal Business Name): RAMEEN KHAN RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 HEALTHWAY DR STE 110
AURORA IL
60504-8184
US

IV. Provider business mailing address

4307 PLANTREE RD
NAPERVILLE IL
60564-1240
US

V. Phone/Fax

Practice location:
  • Phone: 630-392-5499
  • Fax:
Mailing address:
  • Phone: 630-392-5499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberRBT-25-468509
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: