Provider Demographics
NPI:1922312552
Name:ABA MIDWEST LTD.
Entity Type:Organization
Organization Name:ABA MIDWEST LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:M
Authorized Official - Last Name:PELLECCHIA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:630-673-1211
Mailing Address - Street 1:1530 S STATE ST
Mailing Address - Street 2:SUITE 15 N
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2973
Mailing Address - Country:US
Mailing Address - Phone:630-673-1211
Mailing Address - Fax:773-326-0725
Practice Address - Street 1:1530 S STATE ST
Practice Address - Street 2:SUITE 15 N
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2973
Practice Address - Country:US
Practice Address - Phone:630-673-1211
Practice Address - Fax:773-326-0725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-06
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-03-1395103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty