Healthcare Provider Details

I. General information

NPI: 1235710534
Provider Name (Legal Business Name): ABC PATHWAYS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 10/04/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18350 KEDZIE AVE STE 200
HOMEWOOD IL
60430-2759
US

IV. Provider business mailing address

18350 KEDZIE AVE STE 200
HOMEWOOD IL
60430-2759
US

V. Phone/Fax

Practice location:
  • Phone: 708-510-7122
  • Fax: 312-275-8540
Mailing address:
  • Phone: 312-350-7149
  • Fax: 312-275-8540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. VERMA L SMITH
Title or Position: CEO
Credential: BCBA
Phone: 312-350-7149