Healthcare Provider Details

I. General information

NPI: 1023932209
Provider Name (Legal Business Name): SMJ LEARNING ACADEMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 N MICHIGAN AVE
CHICAGO IL
60611-3141
US

IV. Provider business mailing address

1435 BOGGS RD APT 607
DULUTH GA
30096-2395
US

V. Phone/Fax

Practice location:
  • Phone: 312-931-0203
  • Fax:
Mailing address:
  • Phone: 312-931-0203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: JASMINE PENDER
Title or Position: PRESIDENT
Credential:
Phone: 312-931-0203