Healthcare Provider Details

I. General information

NPI: 1407628480
Provider Name (Legal Business Name): TESS A BROWN BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2023
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 W PHILLIP RD STE 108
VERNON HILLS IL
60061-1730
US

IV. Provider business mailing address

W134 NIPPERSINK RD
GENOA CITY WI
53128-1141
US

V. Phone/Fax

Practice location:
  • Phone: 847-231-2626
  • Fax:
Mailing address:
  • Phone: 312-905-5777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-50018
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: