Basic Information
| Provider Information | |||||||||
| NPI: | 1740636851 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LATUSZEK | ||||||||
| FirstName: | JULIANN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 321 S BARRINGTON RD | ||||||||
| Address2: | |||||||||
| City: | SCHAUMBURG | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601935345 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8154691500 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 321 S BARRINGTON RD | ||||||||
| Address2: | |||||||||
| City: | SCHAUMBURG | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601935345 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8154691500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2016 | ||||||||
| LastUpdateDate: | 09/27/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-20-44887 | IL | N | Behavioral Health & Social Service Providers | Behavioral Analyst | 247200000X | N | Technologists, Technicians & Other Technical Service Providers | Technician, Other | 103K00000X | 1-20-44887 | MI | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
ID Information
| ID | Type | State | Issuer | Description | 1-20-44887 | 01 | BACB | OTHER |