Provider Demographics
NPI:1093028128
Name:ABA OF ILLINOIS. LLC
Entity Type:Organization
Organization Name:ABA OF ILLINOIS. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:630-709-5910
Mailing Address - Street 1:928 RUNYAN DR
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-3735
Mailing Address - Country:US
Mailing Address - Phone:630-709-5910
Mailing Address - Fax:815-838-2342
Practice Address - Street 1:928 RUNYAN DR
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60441-3735
Practice Address - Country:US
Practice Address - Phone:630-709-5910
Practice Address - Fax:815-838-2342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-18
Last Update Date:2010-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty