Provider Demographics
NPI:1407277684
Name:UHLIG, MALLORY (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:MALLORY
Middle Name:
Last Name:UHLIG
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 W SCHAUMBURG RD
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60194-3506
Mailing Address - Country:US
Mailing Address - Phone:847-607-1113
Mailing Address - Fax:217-284-9114
Practice Address - Street 1:51 W SCHAUMBURG RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60194-3506
Practice Address - Country:US
Practice Address - Phone:847-607-1113
Practice Address - Fax:217-284-9114
Is Sole Proprietor?:No
Enumeration Date:2013-12-14
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
IL1-17-25487103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist