DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: BRIANNA PETERSON BACB 1-24-75392

MEDICARE: BRIANNA PETERSON BACB 1-24-75392
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
1103K00000XBehavior Analyst1-24-75392IL
2106S00000XBehavior Technician18-48032IL

General Provider Information

NPI Number : 1164911715
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIANNA PETERSON BACB 1-24-75392
Provider Business Mailing Address
First Line : 1808 HARRISON AVE
Second Line :
City : MUNDELEIN
State : IL
Zip : 60060-1062
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 854 TECHNOLOGY WAY STE E
Second Line :
City : LIBERTYVILLE
State : IL
Zip : 60048-5350
Country : US
Telephone Number : 847-816-7200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2018
Last Update Date : 12/10/2025

Similar Medicare Providers

1225064488 — MOBILE THERAPY CENTER OF AMERICA, LLC
Practice Location Address:
854 TECHNOLOGY WAY
LIBERTYVILLE, IL
60048-5350
Practice Phone: 847-816-7200
Practice Fax: 847-816-7210
1205083011 — NICOLE FAUQUIER CCC-SLP
Practice Location Address:
854 TECHNOLOGY WAY
LIBERTYVILLE, IL
60048-5350
Practice Phone: 847-816-7200
Practice Fax:
1639647704 — JIGNA B SHAH LCPC
Practice Location Address:
854 TECHNOLOGY WAY
LIBERTYVILLE, IL
60048-5350
Practice Phone: 847-816-7203
Practice Fax:
1730653049 — ANGELICA GALLEGOS BCBA 1-21-48488
Practice Location Address:
854 TECHNOLOGY WAY
LIBERTYVILLE, IL
60048-5350
Practice Phone: 847-816-7200
Practice Fax:
1083178438 — JENNIFER MARIE KRYSKA MA, BCBA, LBA
Practice Location Address:
854 TECHNOLOGY WAY
LIBERTYVILLE, IL
60048-5350
Practice Phone: 847-816-7200
Practice Fax:
1487287421 — LOURDES RENDON MS, BCBA
Practice Location Address:
854 TECHNOLOGY WAY
LIBERTYVILLE, IL
60048-5350
Practice Phone: 847-816-7200
Practice Fax:

Directions to “ BRIANNA PETERSON BACB 1-24-75392” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.