Healthcare Provider Details

I. General information

NPI: 1023929395
Provider Name (Legal Business Name): KRISTIN MICHELLE RIX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 MILLER DR STE 102
NORTH AURORA IL
60542-5144
US

IV. Provider business mailing address

66 MILLER DR STE 102
NORTH AURORA IL
60542-5144
US

V. Phone/Fax

Practice location:
  • Phone: 603-907-9165
  • Fax: 630-907-9195
Mailing address:
  • Phone: 603-907-9165
  • Fax: 630-907-9195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number152.003797
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: