Healthcare Provider Details

I. General information

NPI: 1093385601
Provider Name (Legal Business Name): MARISA SANCHEZ BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2021
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 BIESTERFIELD RD STE 110
ELK GROVE VILLAGE IL
60007-3393
US

IV. Provider business mailing address

901 BIESTERFIELD RD STE 110
ELK GROVE VILLAGE IL
60007-3393
US

V. Phone/Fax

Practice location:
  • Phone: 312-497-9305
  • Fax:
Mailing address:
  • Phone: 708-533-9667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-22-60315
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: