Healthcare Provider Details

I. General information

NPI: 1083536809
Provider Name (Legal Business Name): ERIN WILTSE BCBA,LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3S140 BARKLEY AVE
WARRENVILLE IL
60555-1505
US

IV. Provider business mailing address

598 PARK PLZ
GLEN ELLYN IL
60137-5718
US

V. Phone/Fax

Practice location:
  • Phone: 571-438-3828
  • Fax:
Mailing address:
  • Phone: 571-438-3828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number152.000369
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: