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General NPI Number Information
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NPI Number | 1184825549
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Entity Type | Individual
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Provider Name | RUCHI SHARMA BCBA (LICENSED, IL)
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Gender | Female
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 5801 MOUNT PLEASANT LN
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City | BELLEVILLE
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State | IL
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Zip | 62223-3944
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Country | US
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Telephone | 618-489-5102
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Fax |
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Provider Business Mailing Address
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Address Line | 415 HOWARD ST APT 1812
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City | EVANSTON
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State | IL
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Zip | 60202-4058
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Country | US
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Telephone | 312-914-8208
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-14-17778
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License Number State | IL
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