Healthcare Provider Details

I. General information

NPI: 1528936697
Provider Name (Legal Business Name): ALIGN ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2025
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 S RACINE AVE UNIT 308
CHICAGO IL
60607-2862
US

IV. Provider business mailing address

222 S RACINE AVE UNIT 308
CHICAGO IL
60607-2862
US

V. Phone/Fax

Practice location:
  • Phone: 785-256-9096
  • Fax:
Mailing address:
  • Phone: 719-640-2465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: DOMINIQUE FISHER
Title or Position: OWNER
Credential: BCBA
Phone: 719-640-2465