Healthcare Provider Details

I. General information

NPI: 1891628350
Provider Name (Legal Business Name): TAYLORED INNOVATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2448 W ADDISON ST APT 3B
CHICAGO IL
60618-5959
US

IV. Provider business mailing address

2448 W ADDISON ST APT 3B
CHICAGO IL
60618-5959
US

V. Phone/Fax

Practice location:
  • Phone: 219-688-1425
  • Fax:
Mailing address:
  • Phone: 219-688-1425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: TAYLOR DANIELLE WILLIS
Title or Position: FOUNDER
Credential: BCBA
Phone: 219-688-1425