Independent With Autism
NPI #1790264927 in Lake Forest, Illinois
Provider Information
- NPI Number
- 1790264927
- Entity Type
- Organization
- Organization Name
- Independent With Autism
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MIND BODY LIFE
- Primary Specialty
- Behavior Analyst
- Enumeration Date
- Aug 8, 2018
- Last Updated
- Aug 8, 2018
Practice Location
- Address
- 100 SAUNDERS RD STE 150
- City
- Lake Forest
- State
- Illinois
- ZIP Code
- 60045-2526
- Phone
- (847) 275-9413
Authorized Official
- Name
- MS. SUSAN PERKOWITZ
- Title
- OWNER
- Phone
- (847) 274-9413
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
| Assistant Behavior Analyst |
| Behavior Analyst |
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