Healthcare Provider Details

I. General information

NPI: 1811819253
Provider Name (Legal Business Name): CHARM ABA COLLABORATIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8909 S COTTAGE GROVE AVE
CHICAGO IL
60619-6955
US

IV. Provider business mailing address

18141 DIXIE HWY STE 202
HOMEWOOD IL
60430-2243
US

V. Phone/Fax

Practice location:
  • Phone: 708-332-8560
  • Fax:
Mailing address:
  • Phone: 708-332-8560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ALAINA COLLINS
Title or Position: MANAGER
Credential:
Phone: 708-332-8560