Provider Demographics
NPI:1891088290
Name:ABA MIDWEST EDUCATION LTD
Entity Type:Organization
Organization Name:ABA MIDWEST EDUCATION LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PELLECCHIA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, MA
Authorized Official - Phone:312-375-1000
Mailing Address - Street 1:1136 S DELANO CT W B201
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3734
Mailing Address - Country:US
Mailing Address - Phone:312-375-1000
Mailing Address - Fax:773-326-0725
Practice Address - Street 1:1136 S DELANO CT W B201
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-3734
Practice Address - Country:US
Practice Address - Phone:312-375-1000
Practice Address - Fax:773-326-0725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-031395103K00000X, 103TM1800X
IL1-118506103K00000X
IL071-004663103TC0700X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1114025434OtherLCP, ILLINOIS
1407069941OtherBEHAVIORAL ANALYST