Healthcare Provider Details

I. General information

NPI: 1124703624
Provider Name (Legal Business Name): JOHN DANIEL BOYER JR. BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14701 S LA GRANGE RD FL 2
ORLAND PARK IL
60462-3226
US

IV. Provider business mailing address

8609 W BRYN MAWR AVE STE 204
CHICAGO IL
60631-3524
US

V. Phone/Fax

Practice location:
  • Phone: 224-205-3058
  • Fax:
Mailing address:
  • Phone: 773-644-7787
  • Fax: 224-241-3132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: