Provider Demographics
NPI:1871252817
Name:INSTRUCTIONAL ABA CONSULTANTS WAIVER SERVICES
Entity Type:Organization
Organization Name:INSTRUCTIONAL ABA CONSULTANTS WAIVER SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:K
Authorized Official - Last Name:TOPALOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-601-3151
Mailing Address - Street 1:1975 MC DOWELL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-6533
Mailing Address - Country:US
Mailing Address - Phone:331-229-8839
Mailing Address - Fax:331-256-1900
Practice Address - Street 1:1975 MC DOWELL RD STE 101
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-6533
Practice Address - Country:US
Practice Address - Phone:331-229-8839
Practice Address - Fax:331-256-1900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health