Healthcare Provider Details

I. General information

NPI: 1972497535
Provider Name (Legal Business Name): LISA R STRICKLIN RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 S MICHIGAN AVE STE 900
CHICAGO IL
60604-4393
US

IV. Provider business mailing address

717 N CENTER ST APT N
BRAIDWOOD IL
60408-1472
US

V. Phone/Fax

Practice location:
  • Phone: 813-395-1073
  • Fax: 772-675-9100
Mailing address:
  • Phone: 779-205-5564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-442378
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: