Provider Demographics
NPI:1942959994
Name:ROSARIO, DESTINY MARIBEL (BCBA)
Entity Type:Individual
Prefix:
First Name:DESTINY
Middle Name:MARIBEL
Last Name:ROSARIO
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:DOMINIK
Other - Middle Name:MIKAH
Other - Last Name:ROSARIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8201 CASS AVE
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-5314
Mailing Address - Country:US
Mailing Address - Phone:630-590-5571
Mailing Address - Fax:
Practice Address - Street 1:1300 REMINGTON RD STE K
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4800
Practice Address - Country:US
Practice Address - Phone:847-496-5513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-18
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty