Basic Information
| Provider Information | |||||||||
| NPI: | 1407277684 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | UHLIG | ||||||||
| FirstName: | MALLORY | ||||||||
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| Credential: | M.S., B.C.B.A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 51 W SCHAUMBURG RD | ||||||||
| Address2: | |||||||||
| City: | SCHAUMBURG | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601943506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476071113 | ||||||||
| FaxNumber: | 2172849114 | ||||||||
| Practice Location | |||||||||
| Address1: | 51 W SCHAUMBURG RD | ||||||||
| Address2: | |||||||||
| City: | SCHAUMBURG | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601943506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476071113 | ||||||||
| FaxNumber: | 2172849114 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2013 | ||||||||
| LastUpdateDate: | 06/03/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 222Q00000X | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist | 103K00000X | 1-17-25487 | IL | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.