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General NPI Number Information
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NPI Number | 1396914339
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Entity Type | Organization
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Legal Business Name | ABA MIDWEST LTD.
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Dates
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Enumeration Date | 02/25/2008
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Last Update Date | 02/25/2008
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Provider Practice Location Address
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Address Line | 1530 S STATE ST
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City | CHICAGO
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State | IL
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Zip | 60605-2964
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Country | US
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Telephone | 630-673-1211
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Fax |
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Provider Business Mailing Address
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Address Line | 720 CAMPBELL ST
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City | JOLIET
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State | IL
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Zip | 60435-6908
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Country | US
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Telephone | 815-690-1400
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Fax | 815-727-7603
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Authorized Official
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Title or Position | SENIOR BEHAVIOR ANALYST
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Name | MISS JANICE PELLECCHIA
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Credential | M.A., B.C.B.A.
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Telephone | 630-673-1211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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