MEDICARE: SARAH ELIZABETH VESELY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-25-86644	IL
2	106S00000X	Behavior Technician	RBT-21-194083	KS
3	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1043965676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH ELIZABETH VESELY

Provider Business Mailing Address
First Line	:	985450 NEBRASKA MEDICAL CTR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68198-5450
Country	:	US
Telephone Number	:	402-559-8943
Fax Number	:	402-559-5753

Provider Business Practice Location Address
First Line	:	2762 N LINCOLN AVE UNIT B
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-2425
Country	:	US
Telephone Number	:	872-260-6006
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2022
Last Update Date	:	01/12/2026

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