Provider Demographics
NPI:1831843861
Name:SAWYER, MADELINE R (BCBA)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:R
Last Name:SAWYER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6908 YOUNG CT
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-1917
Mailing Address - Country:US
Mailing Address - Phone:708-717-1278
Mailing Address - Fax:
Practice Address - Street 1:16626 W 159TH ST
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60441-8018
Practice Address - Country:US
Practice Address - Phone:708-792-0162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst