Healthcare Provider Details
I. General information
NPI: 1316865769
Provider Name (Legal Business Name): SARAH KVAM MA, BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1755 PARK ST STE 100
NAPERVILLE IL
60563-8477
US
IV. Provider business mailing address
1732 HARROW CT APT C
WHEATON IL
60189-8342
US
V. Phone/Fax
- Phone: 630-884-5761
- Fax:
- Phone: 630-400-3101
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 152.000905 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: