Provider Demographics
NPI:1295021269
Name:CHICAGO AUTISM AND BEHAVIOR SPECIALISTS
Entity Type:Organization
Organization Name:CHICAGO AUTISM AND BEHAVIOR SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BCBA
Authorized Official - Prefix:MISS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:808-441-2328
Mailing Address - Street 1:901 W HAWTHORN DRIVE
Mailing Address - Street 2:
Mailing Address - City:ITASCA
Mailing Address - State:IL
Mailing Address - Zip Code:60143
Mailing Address - Country:US
Mailing Address - Phone:800-844-1232
Mailing Address - Fax:800-844-1232
Practice Address - Street 1:901 W HAWTHORN DRIVE
Practice Address - Street 2:
Practice Address - City:ITASCA
Practice Address - State:IL
Practice Address - Zip Code:60143
Practice Address - Country:US
Practice Address - Phone:800-844-1232
Practice Address - Fax:800-844-1232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-28
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-07-3892103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty