MEDICARE: MS. JULIANN LATUSZEK 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
1	103K00000X	Behavior Analyst	1-20-44887	IL
2	247200000X	Other Technician
3	103K00000X	Behavior Analyst	1-20-44887	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1-20-44887	OTHER		BACB

General Provider Information

NPI Number	:	1740636851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JULIANN LATUSZEK BCBA

Provider Business Mailing Address
First Line	:	321 S BARRINGTON RD
Second Line	:
City	:	SCHAUMBURG
State	:	IL
Zip	:	60193-5345
Country	:	US
Telephone Number	:	815-469-1500
Fax Number	:

Provider Business Practice Location Address
First Line	:	321 S BARRINGTON RD
Second Line	:
City	:	SCHAUMBURG
State	:	IL
Zip	:	60193-5345
Country	:	US
Telephone Number	:	815-469-1500
Fax Number	:

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

Provider Enumeration Date	:	05/06/2016
Last Update Date	:	09/27/2022

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