Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACK KELLY, BCBA
ActiveBehavior Analyst · LAKE BLUFF, IL
Registration Details
- NPI Number
- 1396383030
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 12, 2019 (6.3889477848205 yrs)
- Last Updated
- Aug 12, 2021
- License
-
1-20-45283 (IL)
Practice Information
- Address
-
917 SHERWOOD DR STE 201LAKE BLUFF, IL, 600442235Browse IL providers · Browse ZIP 60044
- Phone
- 8774864140
- Primary Specialty
-
Behavior Analyst
103K00000X
- Additional Specialty
- Behavior Analyst
Other Behavior Analyst Providers in LAKE BLUFF, IL
| Name | Credential | NPI |
|---|---|---|
| STEPHANIE KAE VOLKOV | BCBA | 1184180473 |
| KELSEY WELZEN | — | 1285190983 |
| NEDA ESFAHANI | — | 1013560465 |
| DERRICK L VICTORIAN | M.A. | 1508471830 |
| KAYLEEN MARIE FLORES | MS, BCBA | 1740869643 |
| DR. AMIE KRUMMICK | PH.D | 1851160683 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.