MEDICARE: CASSANDRA AKER

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	1-20-42107	IL

General Provider Information

NPI Number	:	1699251934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA AKER

Provider Business Mailing Address
First Line	:	5 REVERE DR STE 120
Second Line	:
City	:	NORTHBROOK
State	:	IL
Zip	:	60062-8005
Country	:	US
Telephone Number	:	847-807-3917
Fax Number	:	847-348-3706

Provider Business Practice Location Address
First Line	:	7177 CRIMSON RIDGE DR
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61107-6235
Country	:	US
Telephone Number	:	847-807-3917
Fax Number	:	847-348-3706

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

Provider Enumeration Date	:	07/18/2018
Last Update Date	:	08/08/2020

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