MEDICARE: FALE LA ABA PC

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

General Provider Information

NPI Number	:	1477496305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FALE LA ABA PC

Provider Business Mailing Address
First Line	:	3030 FINLEY RD
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1163
Country	:	US
Telephone Number	:	217-416-6600
Fax Number	:

Provider Business Practice Location Address
First Line	:	3030 FINLEY RD
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1163
Country	:	US
Telephone Number	:	217-416-6600
Fax Number	:

Authorized Official
Title or Position	:	OWNER/FOUNDER
Name	:	KAILANI MARIE BARTLEY
Credential	:
Telephone Number	:	217-416-6600

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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