Healthcare Provider Details

I. General information

NPI: 1790619880
Provider Name (Legal Business Name): CRESPO COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

7748 TAYLOR ST
FOREST PARK IL
60130-2109
US

IV. Provider business mailing address

7748 TAYLOR ST
FOREST PARK IL
60130-2109
US

V. Phone/Fax

Practice location:
  • Phone: 312-953-9696
  • Fax:
Mailing address:
  • Phone: 312-953-9696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MS. NADINE CRESPO-GARCIA
Title or Position: BCBA/OWNER
Credential: BCBA, LBA
Phone: 312-953-9696