Healthcare Provider Details

I. General information

NPI: 1306495585
Provider Name (Legal Business Name): BERTLING ABA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2019
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15419 E 127TH ST STE 300
LEMONT IL
60439-6494
US

IV. Provider business mailing address

712 MCCARTHY RD
LEMONT IL
60439-4043
US

V. Phone/Fax

Practice location:
  • Phone: 630-217-1292
  • Fax:
Mailing address:
  • Phone: 630-217-1292
  • 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: MYRA J BERTLING
Title or Position: OWNER
Credential:
Phone: 630-217-1292