Healthcare Provider Details
I. General information
NPI: 1285117283
Provider Name (Legal Business Name): STEVE MCCUE BCBA 1-19-36099
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/14/2018
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2450 WESTFIELD DR
ELGIN IL
60124-7836
US
IV. Provider business mailing address
2450 WESTFIELD DR
ELGIN IL
60124-7836
US
V. Phone/Fax
- Phone: 773-644-8224
- Fax: 224-241-3132
- Phone: 773-644-8224
- Fax: 224-241-3132
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 1-19-36099 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: