Healthcare Provider Details

I. General information

NPI: 1871452870
Provider Name (Legal Business Name): ILLINOIS BEHAVIOR ANALYSIS GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2026
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7228 CIRCLE AVE
FOREST PARK IL
60130-1163
US

IV. Provider business mailing address

1010 LAKE ST UNIT 225
OAK PARK IL
60301-1147
US

V. Phone/Fax

Practice location:
  • Phone: 630-632-4350
  • Fax:
Mailing address:
  • Phone: 630-632-4350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: MOHAMED KAREM ALNATAFGI
Title or Position: CEO
Credential:
Phone: 630-895-0295