Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1831377944 Deactivated / Inactive NPI Female Practitioner

Dianna Katherine Poulos , MA, BCBA

Behavior Analyst • Island Lake, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dianna Poulos has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 31, 2008
NPI Deactivation Date April 30, 2026
Total Practice Duration ~18 Years of Practice (2008 – 2026)

Professional Overview & Biography Verified Profile Summary

Dianna Poulos, MA, BCBA was a registered Behavior Analyst practicing in Island Lake, IL. Throughout an active medical career spanning 18 years, Dianna Poulos provided care at the practice location at 4363 WATERS EDGE DR until profile deactivation on 2026-04-30.

Practice Location & Contact Primary Location

Practice Address

4363 Waters Edge Dr

Island Lake, IL 600428221

Telephone 8473315370
Associated Practice Facility / Clinic
🏢 Impacting Autism, Llc Facility NPI 1740522549

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Analyst in Island Lake, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.3 Yrs
Regional Practice Density
2 Specialists

Practicing in Island Lake, IL (3105 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

State License IL 1-09-6494

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated April 30, 2026

Record deactivated on April 30, 2026

NPI Profile Active September 12, 2012

NPI status registered as active in NPPES database

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Updated Practice Location September 12, 2012

Registered at 4363 WATERS EDGE DR, ISLAND LAKE, IL 600428221 (Tel: 8473315370)

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Updated Business Mailing Address September 12, 2012

Registered at 4363 WATERS EDGE DR, ISLAND LAKE, IL 600428221 (Tel: 8473315370)

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Provider Name / Credentials Updated September 12, 2012

Recorded as DIANNA POULOS, M.A.,BCBA

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 12, 2012

Behavior Analyst (License #1-09-6494 in IL)

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Initial NPI Registration & Enumeration January 31, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1831377944
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 31, 2008
Last Update: September 12, 2012
Deactivation Date: April 30, 2026

Mailing Address

4363 Waters Edge Dr

Island Lake, IL 600428221

Phone: 8473315370

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.