Healthcare Provider Details

I. General information

NPI: 1609383330
Provider Name (Legal Business Name): HANNAH KUZNETSKY MS, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2018
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 OLD ORCHARD RD STE 15
SKOKIE IL
60077-1027
US

IV. Provider business mailing address

5225 OLD ORCHARD RD STE 15
SKOKIE IL
60077-1027
US

V. Phone/Fax

Practice location:
  • Phone: 847-779-3278
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-17-29013
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: