Healthcare Provider Details

I. General information

NPI: 1477180537
Provider Name (Legal Business Name): KIMVERLI A. HALILI MS, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIMVERLI ASHLY ADAMOS HALILI

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 W ALGONQUIN RD
PALATINE IL
60067-4791
US

IV. Provider business mailing address

1760 W ALGONQUIN RD
PALATINE IL
60067-4791
US

V. Phone/Fax

Practice location:
  • Phone: 773-236-2441
  • Fax:
Mailing address:
  • Phone: 847-358-5510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-22-59993
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: