Provider Demographics
NPI:1982077194
Name:CHICAGO AUTISM & BEHAVIOR SPECIALISTS
Entity type:Organization
Organization Name:CHICAGO AUTISM & BEHAVIOR SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WASNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-844-1232
Mailing Address - Street 1:901 W HAWTHORN DR
Mailing Address - Street 2:
Mailing Address - City:ITASCA
Mailing Address - State:IL
Mailing Address - Zip Code:60143-2056
Mailing Address - Country:US
Mailing Address - Phone:800-844-1232
Mailing Address - Fax:800-844-1232
Practice Address - Street 1:901 W HAWTHORN DR
Practice Address - Street 2:
Practice Address - City:ITASCA
Practice Address - State:IL
Practice Address - Zip Code:60143-2056
Practice Address - Country:US
Practice Address - Phone:800-844-1232
Practice Address - Fax:800-844-1232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1831348028103K00000X
IL1821203100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty