Healthcare Provider Details

I. General information

NPI: 1831017177
Provider Name (Legal Business Name): DJJE HOLDINGS LLC-THE PLACE FOR CHILDREN WITH AUTISM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8609 W BRYN MAWR AVE STE 204
CHICAGO IL
60631-3524
US

IV. Provider business mailing address

850 N LAKE SHORE DR
CHICAGO IL
60611-6324
US

V. Phone/Fax

Practice location:
  • Phone: 773-644-7787
  • Fax:
Mailing address:
  • Phone: 630-770-7962
  • 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: ISABELLA PEARL MOHATT
Title or Position: BCBA
Credential: BCBA
Phone: 630-770-7962