Basic Information
Provider Information | |||||||||
NPI: | 1437574498 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | VOSTERS | ||||||||
FirstName: | MEGAN | ||||||||
MiddleName: | E | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | PHD, BCBA-D | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | SCHILTZ | ||||||||
OtherFirstName: | MEGAN | ||||||||
OtherMiddleName: | E | ||||||||
OtherNamePrefix: | MS. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | PO BOX 639561 | ||||||||
Address2: |   | ||||||||
City: | CINCINNATI | ||||||||
State: | OH | ||||||||
PostalCode: | 452639561 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8442477222 | ||||||||
FaxNumber: | 2154898766 | ||||||||
Practice Location | |||||||||
Address1: | 85 REVERE DR STE AA | ||||||||
Address2: |   | ||||||||
City: | NORTHBROOK | ||||||||
State: | IL | ||||||||
PostalCode: | 600628001 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8442477222 | ||||||||
FaxNumber: | 2154898766 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 02/27/2014 | ||||||||
LastUpdateDate: | 08/31/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 08/31/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-13-14885 | IL | Y |   | Behavioral Health & Social Service Providers | Behavioral Analyst |   | 103K00000X | 77140 | WI | N |   | Behavioral Health & Social Service Providers | Behavioral Analyst |   |
No ID Information.