Provider Demographics
NPI:1033631981
Name:WISE, SASKIA (BCBA)
Entity Type:Individual
Prefix:
First Name:SASKIA
Middle Name:
Last Name:WISE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:SASKIA
Other - Middle Name:
Other - Last Name:ALESSANDRA JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:524 WAUBONSEE CIR
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-8730
Mailing Address - Country:US
Mailing Address - Phone:630-822-6793
Mailing Address - Fax:
Practice Address - Street 1:1760 W ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-4791
Practice Address - Country:US
Practice Address - Phone:847-358-5510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0-12-5140106E00000X
1-21-48407103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst