Provider Demographics
NPI:1396236956
Name:HARRIS, CHARI LYNN (RBT-17-44356)
Entity type:Individual
Prefix:MS
First Name:CHARI
Middle Name:LYNN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RBT-17-44356
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 S BUFFALO GROVE RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-3543
Mailing Address - Country:US
Mailing Address - Phone:847-975-3712
Mailing Address - Fax:
Practice Address - Street 1:3385 N ARLINGTON HEIGHTS RD STE K
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-7702
Practice Address - Country:US
Practice Address - Phone:847-260-7013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-19
Last Update Date:2018-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILRBT-17-44356106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician