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2530 Ridge Ave Ste 103 Evanston IL 60201-2493 | |
| (312) 725-8968 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2530 Ridge Ave Ste 103, Evanston, Illinois |
| Authorized Official Name and Position | Katie Saltzman (MANAGER) |
| Authorized Official Contact | 3127258968 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2530 Ridge Ave Ste 103 Evanston IL 60201-2493 Ph: (312) 725-8968 | 2530 Ridge Ave Ste 103 Evanston IL 60201-2493 Ph: (312) 725-8968 |
| NPI Number | 1790498855 |
|---|---|
| Provider Enumeration Date | 01/03/2023 |
| Last Update Date | 02/05/2025 |
| Certification Date | 02/05/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790498855 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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