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NPI Code Detail

MEDICARE: ANNA MCFADDEN BCBA

MEDICARE: ANNA MCFADDEN BCBA
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 Analyst152.000840IL
2103K00000XBehavior Analyst1-18-33569IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11-18-33569OTHERMABCBA

General Provider Information

NPI Number : 1588218283
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA MCFADDEN BCBA
Provider Business Mailing Address
First Line : 2400 N SHEFFIELD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60614-3936
Country : US
Telephone Number : 773-389-2202
Fax Number : 773-389-2203
Provider Business Practice Location Address
First Line : 2400 N SHEFFIELD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60614-3936
Country : US
Telephone Number : 773-389-2202
Fax Number : 773-389-2203
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2019
Last Update Date : 06/12/2025

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