MEDICARE: REBEKAH ISGITT

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	1-22-59943	NC
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1275194680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBEKAH ISGITT

Provider Business Mailing Address
First Line	:	7645 N SHERIDAN RD APT 413
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-1322
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3417 N KENNICOTT AVE STE A
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-7824
Country	:	US
Telephone Number	:	844-263-1613
Fax Number	:

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

Provider Enumeration Date	:	06/26/2019
Last Update Date	:	10/24/2023

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