MEDICARE: FIRST ADVANTAGE

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1720939507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST ADVANTAGE

Provider Business Mailing Address
First Line	:	1209 OAKDALE ST
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62703-2045
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1209 OAKDALE ST
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62703-2045
Country	:	US
Telephone Number	:	217-836-5775
Fax Number	:

Authorized Official
Title or Position	:	BEHAVIORAL TECHNICIAN
Name	:	RANIYAH DOWDELL
Credential	:
Telephone Number	:	217-836-5775

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

Similar Medicare Providers

1467527317 — DR. MICHAEL B HALLE MD
Practice Location Address:

2101 E JEFFERSON ST , KAISER PERMANENTE SPRINGFIELD MEDICARE ENROLLMENT
ROCKVILLE, MD
20852-4908

Practice Phone: 701-922-1000
Practice Fax: 703-922-1039

1669323465 — RANIYAH DOWDELL
Practice Location Address:

1209 OAKDALE ST
SPRINGFIELD, IL
62703-2045

Practice Phone: 217-836-5775
Practice Fax:

1821003070 — WALGREEN CO
Practice Location Address:

2640 E SUNSHINE ST
SPRINGFIELD, MO
65804-2045

Practice Phone: 417-885-1274
Practice Fax:

1669446159 — DOMENIC PISANO DO
Practice Location Address:

196 W SPROUL RD , SUITE 106
SPRINGFIELD, PA
19064-2045

Practice Phone: 610-543-4000
Practice Fax: 610-543-4003

1386607828 — MR. STEVEN HUDYMA ATC, PTA
Practice Location Address:

196 W SPROUL RD , PAV. I SUITE 110
SPRINGFIELD, PA
19064-2045

Practice Phone: 610-328-8830
Practice Fax: 610-328-8981

1730294141 — AMY ERDMAN DO
Practice Location Address:

196 W SPROUL RD
SPRINGFIELD, PA
19064-2045

Practice Phone: 610-328-7860
Practice Fax:

Directions to “FIRST ADVANTAGE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.