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NPI Code Detail

MEDICARE: PAYTON MARIE PLANITZ

MEDICARE: PAYTON MARIE PLANITZ
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1710832654
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAYTON MARIE PLANITZ
Provider Business Mailing Address
First Line : 5220 6TH STREET FRONTAGE RD E STE 1700
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62703-5771
Country : US
Telephone Number : 217-525-8332
Fax Number :
Provider Business Practice Location Address
First Line : 4559 BENES AVE
Second Line :
City : GLEN CARBON
State : IL
Zip : 62034-1541
Country : US
Telephone Number : 217-525-8332
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2026
Last Update Date : 03/04/2026

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Directions to “ PAYTON MARIE PLANITZ ” Practice Location

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