MEDICARE: CRESPO COLLECTIVE

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

General Provider Information

NPI Number	:	1790619880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRESPO COLLECTIVE

Provider Business Mailing Address
First Line	:	7748 TAYLOR ST
Second Line	:
City	:	FOREST PARK
State	:	IL
Zip	:	60130-2109
Country	:	US
Telephone Number	:	312-953-9696
Fax Number	:

Provider Business Practice Location Address
First Line	:	7748 TAYLOR ST
Second Line	:
City	:	FOREST PARK
State	:	IL
Zip	:	60130-2109
Country	:	US
Telephone Number	:	312-953-9696
Fax Number	:

Authorized Official
Title or Position	:	BCBA/OWNER
Name	:	MS. NADINE CRESPO-GARCIA
Credential	:	BCBA, LBA
Telephone Number	:	312-953-9696

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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Directions to “CRESPO COLLECTIVE ” Practice Location

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