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General NPI Number Information
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NPI Number | 1912729153
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Entity Type | Individual
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Provider Name | JESSICA ANN SCHULZKI BEHAVIOR ANALYST
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Gender | Female
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 301 S PROSPECT RD STE 2
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City | BLOOMINGTON
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State | IL
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Zip | 61704-4908
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Country | US
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Telephone | 773-644-7787
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Fax | 224-241-3132
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Provider Business Mailing Address
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Address Line | 8609 W BRYN MAWR AVE STE 204
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City | CHICAGO
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State | IL
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Zip | 60631-3524
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Country | US
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Telephone | 773-644-7787
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 152.000873
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License Number State | IL
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