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General NPI Number Information
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NPI Number | 1386539161
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Entity Type | Individual
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Provider Name | GABRIELLE ENNA
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Gender | Female
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 332 S MICHIGAN AVE STE 900
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City | CHICAGO
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State | IL
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Zip | 60604-4393
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Country | US
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Telephone | 779-772-3647
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 ROOSEVELT RD
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City | MACHESNEY PARK
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State | IL
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Zip | 61115-2114
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Country | US
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Telephone | 779-772-3647
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-25-443807
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License Number State | IL
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