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General NPI Number Information
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NPI Number | 1235710534
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Entity Type | Organization
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Legal Business Name | ABC PATHWAYS, LLC
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Dates
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Enumeration Date | 04/19/2021
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Last Update Date | 06/10/2022
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Provider Practice Location Address
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Address Line | 17800 SARAH LN
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City | COUNTRY CLUB HILLS
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State | IL
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Zip | 60478-4945
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Country | US
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Telephone | 312-350-7149
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Fax |
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Provider Business Mailing Address
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Address Line | 17800 SARAH LN
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City | COUNTRY CLUB HILLS
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State | IL
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Zip | 60478-4945
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Country | US
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Telephone | 312-350-7149
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. VERMA L SMITH
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Credential | BCBA
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Telephone | 312-350-7149
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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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 |
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License Number State |
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