Healthcare Provider Details

I. General information

NPI: 1790230845
Provider Name (Legal Business Name): CORI MARIE GILBERT BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2016
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 N KEDZIE AVE
CHICAGO IL
60625-5009
US

IV. Provider business mailing address

3106 N TROY ST
CHICAGO IL
60618-6905
US

V. Phone/Fax

Practice location:
  • Phone: 630-300-3400
  • Fax:
Mailing address:
  • Phone: 309-360-9260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0-15-6727
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: