Healthcare Provider Details
I. General information
NPI: 1609354745
Provider Name (Legal Business Name): ERIKA ELLEN STALZER BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/31/2018
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10201 S CICERO AVE STE C
OAK LAWN IL
60453-4672
US
IV. Provider business mailing address
16150 PAMELA CT
OAK FOREST IL
60452-3731
US
V. Phone/Fax
- Phone: 815-469-1500
- Fax:
- Phone: 630-903-7115
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 152000899 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | 18-61924 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: