Provider Demographics
NPI:1083238729
Name:ATLAS BEHAVIOR SERVICES
Entity Type:Organization
Organization Name:ATLAS BEHAVIOR SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:EVONNE
Authorized Official - Last Name:HILDEBRAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-617-9835
Mailing Address - Street 1:301 ALBERS ST
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:IL
Mailing Address - Zip Code:62339-1006
Mailing Address - Country:US
Mailing Address - Phone:217-617-9835
Mailing Address - Fax:
Practice Address - Street 1:301 ALBERS ST
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:IL
Practice Address - Zip Code:62339-1006
Practice Address - Country:US
Practice Address - Phone:217-617-9835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-28
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty