Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1396383030 Individual Practitioner Male Practitioner

Jack Kelly , BCBA

Behavior Analyst • Lake Bluff, IL

Professional Overview & Biography Verified Profile Summary

Jack Kelly, BCBA is a registered healthcare professional specializing in Behavior Analyst in Lake Bluff, IL. Practice services are available at 917 SHERWOOD DR STE 201 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

917 Sherwood Dr Ste 201

Lake Bluff, IL 600442235

Telephone 8774864140
Associated Practice Facility / Clinic
🏢 North Shore Pediatric Therapy Facility NPI 1811909492

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Analyst in Lake Bluff, IL

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

Practicing in Lake Bluff, 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

CMS Verified: 2021-08-12
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

State License IL 1-20-45283

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.

Assistant Behavior Analyst

NUCC Taxonomy Code: 106E00000X

An assistant behavior analyst is qualified by Behavior Analyst Certification Board certification and/or a state-issued license or credential in behavior analysis to practice under the supervision of an appropriately credentialed professional behavior analyst. An assistant behavior analyst delivers services consistent with the dimensions of applied behavior analysis and supervision requirements defined in state laws or regulations and/or national certification standards. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing behavior-analytic treatment plans, training and supervising others in implementation of components of treatment plans, and direct implementation of treatment plans.

Secondary Practice Locations

1975 Mcdowell Rd. #101

Naperville, IL 60563

Phone: 3312298839

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1003339896

Master of Arts, Board Certified Behavior Analyst

Kristen Martin , MS, OTR, L

Occupational Therapist

NPI 1003482985

Master of Science, Occupational Therapist Registered, L

Annamarie Guieb

Behavior Technician

NPI 1003632175
Marissa Keo

Behavior Technician

NPI 1003643974
Jenifer Martinez

Behavior Technician

NPI 1003666181
Refath Haque

Behavior Technician

NPI 1003693797

Career & Practice History Timeline

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

10 Historical Events
📍
Updated Practice Location August 12, 2021

Registered at 917 SHERWOOD DR STE 201, LAKE BLUFF, IL 600442235 (Tel: 8774864140)

📍
Updated Business Mailing Address August 12, 2021

Registered at 426 W BELMONT AVE APT 807, CHICAGO, IL 606574721 (Tel: 7733864024)

👤
Provider Name / Credentials Updated August 12, 2021

Recorded as JACK KELLY, BCBA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 12, 2021

Behavior Analyst (License #1-20-45283 in IL)

NPI Profile Active December 12, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location December 12, 2019

Registered at 1975 MCDOWELL RD. #101, NAPERVILLE, IL 60563 (Tel: 3312298839)

📍
Updated Business Mailing Address December 12, 2019

Registered at 2139 W TOUHY AVE, CHICAGO, IL 606453505 (Tel: 7733864024)

👤
Provider Name / Credentials Updated December 12, 2019

Recorded as JACK KELLY

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 12, 2019

Assistant Behavior Analyst

🟢
Initial NPI Registration & Enumeration December 12, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Jack Kelly. Be the first to share your experience!

Sign in to leave a review for Jack Kelly

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1396383030
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 12, 2019
Last Update: August 12, 2021
Sole Proprietor: No

Mailing Address

426 W Belmont Ave Apt 807

Chicago, IL 606574721

Phone: 7733864024

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.