Healthcare Provider Details

I. General information

NPI: 1790454122
Provider Name (Legal Business Name): ANYLA KRASNIQI BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 EXECUTIVE PL STE 201
GENEVA IL
60134-3805
US

IV. Provider business mailing address

1250 EXECUTIVE PL STE 201
GENEVA IL
60134-3805
US

V. Phone/Fax

Practice location:
  • Phone: 815-223-2237
  • Fax: 815-327-3440
Mailing address:
  • Phone: 815-223-2237
  • Fax: 815-327-3440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: