=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154297414
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAITLYN SVETLIK
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/14/2025
-----------------------------------------------------
Last Update Date | 10/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 220 E ROOSEVELT RD
-----------------------------------------------------
City | VILLA PARK
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60181-3500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-601-8625
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6434 WOODRIDGE DR
-----------------------------------------------------
City | WOODRIDGE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60517-1308
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-532-1200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number | RBT-24-380778
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------