JACK KELLY BCBA
NPI 1396383030
Behavior Analyst in Lake Bluff, IL
NPI Status: Active since December 12, 2019
Contact Information
917 SHERWOOD DR STE 201
LAKE BLUFF, IL
ZIP 60044
Phone: (877) 486-4140
- Individual
- Male
- Behavior Analyst
- Accepts Insurance
About JACK KELLY
This page provides the complete NPI Profile along with additional information for Jack Kelly, a provider established in Lake Bluff, Illinois with a medical specialization in Behavior Analyst. The healthcare provider is registered in the NPI registry with number 1396383030 assigned on December 2019. The practitioner's primary taxonomy code is 103K00000X with license number 1-20-45283 (IL). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1396383030
- Provider Name
- JACK KELLY BCBA
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044
- Location Phone
- (877) 486-4140
- Mailing Address
- 426 W BELMONT AVE APT 807 CHICAGO, IL 60657
- Mailing Phone
- (773) 386-4024
- Is Sole Proprietor?
- No
- Enumeration Date
- 12-12-2019
- Last Update Date
- 08-12-2021
- Code Navigator
Location Map
Secondary Locations
- 1975 McDowell Rd. #101
Naperville, IL 60563
(331) 229-8839
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Behavior Analyst
- Taxonomy Code
- 103K00000X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 1-20-45283
- License State
- IL
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 106E00000X | Behavioral Health & Social Service Providers | Assistant Behavior Analyst |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Choice Preferred Bronze PPO? 201 - PPO
- Blue Choice Preferred Bronze PPO? 701 - PPO
- Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
- Blue Choice Preferred Gold PPO? 204 - PPO
- Blue Choice Preferred Gold PPO? 901 - PPO
- Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
- Blue Choice Preferred Security PPO? 200 - PPO
- Blue Choice Preferred Silver PPO? 203 - PPO
- Blue Choice Preferred Silver PPO? 801 - PPO
- Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
- Blue Precision Bronze HMO? 205 - HMO
- Blue Precision Bronze HMO? 701 - HMO
- Blue Precision Bronze HMO? Standard - Select Rx Copays - HMO
- Blue Precision Gold HMO? 207 - HMO
- Blue Precision Gold HMO? 703 - HMO
- Blue Precision Gold HMO? Standard - Rx Copays - HMO
- Blue Precision Silver HMO? 206 - HMO
- Blue Precision Silver HMO? 704 - HMO
- Blue Precision Silver HMO? Standard - Select Rx Copays - HMO
- MyBlue Plus Bronze? 903 - POS
- Blue AdvanceHealth Bronze - Neighborhood Network - HMO
- Blue AdvanceHealth Gold - Neighborhood Network - HMO
- Blue AdvanceHealth Silver - Neighborhood Network - HMO
- Blue EverydayHealth Gold - Neighborhood Network - HMO
- Blue EverydayHealth Silver - Neighborhood Network - HMO
- Blue Portfolio HSA Bronze - Neighborhood Network - HMO
- Blue Portfolio HSA Gold - Statewide PPO Network - PPO
- Blue PPO PremierHealth Silver - Statewide PPO Network - PPO
- Blue PPO PremierHealth Gold - Statewide PPO Network - PPO
- Blue PPO StandardHealth Gold - Statewide PPO Network - PPO
- Blue PPO StandardHealth Silver - Statewide PPO Network - PPO
- Blue StandardHealth Bronze - Neighborhood Network - HMO
- Blue StandardHealth Gold - Neighborhood Network - HMO
- Blue StandardHealth Silver - Neighborhood Network - HMO
- Bronze Classic 4700 - HMO
- Bronze Classic Standard - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Gold Classic - HMO
- Gold Classic Standard - HMO
- Secure - HMO
- Silver Classic Standard - HMO
- Silver Elite Saver Plus - HMO
- Silver Simple Chronic Care CKM - HMO
- Silver Simple PCP Saver - HMO
- Silver Simple Specialist Saver with COPD - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 9 | 6 | 3 | 8 | 3 | 0 | 3 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 18 | 6 | 6 | 8 | 6 | 0 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 8 + 6 + 6 + 8 + 6 + 0 + 6 + 24 = 70 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1396383030 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1316469190 | AUNDREA MONIQUE MARTINEZ Individual | Speech-Language Pathologist | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (877) 486-4140 |
| 1396130977 | AMIE KRAMP OTR/L Individual | Occupational Therapist | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (877) 486-4140 |
| 1346744380 | RONIT L NISSIM LPC Individual | Counselor (Professional) | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (224) 724-1630 |
| 1326518044 | ABIGAIL GIRGIS Individual | Behavior Technician | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (877) 486-4140 |
| 1669944674 | RACHAEL GIRMSCHEID Individual | Behavior Technician | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (877) 486-4140 |
| 1790337277 | ABYGAIL ROCIO PEREZ Individual | Behavior Technician | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (847) 486-4140 |
| 1811534688 | LAURIE RETZKY Individual | Social Worker (Clinical) | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (877) 486-4140 |
| 1285190983 | KELSEY WELZEN Individual | Behavior Analyst | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (877) 486-4140 |
| 1538786058 | PATRICIA CORDOBA Individual | Behavior Technician | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (877) 486-4140 |
| 1699381889 | EMILY CLEMENS M.S., CCC-SLP Individual | Speech-Language Pathologist | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (877) 486-4140 |
| 1053919373 | SIERRA JONES OTR/L Individual | Occupational Therapist | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (877) 486-4140 |
| 1184180473 | STEPHANIE KAE VOLKOV BCBA Individual | Behavior Analyst | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (877) 486-4140 |
| 1558954289 | KATHLEEN MARIE BURKE OT Individual | Occupational Therapist | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (866) 815-6592 |
| 1740869643 | KAYLEEN MARIE FLORES MS, BCBA Individual | Behavior Analyst | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (866) 815-6592 |
| 1104400761 | HANNAH NEAL RBT Individual | Behavior Technician | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (877) 486-4140 |
| 1003482985 | KRISTEN MARTIN MS, OTR/L Individual | Occupational Therapist | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (877) 486-4140 |
| 1255005401 | HAYLEY LAKIN Individual | Social Worker | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (877) 486-4140 |
| 1912671561 | DR. ANITA BUKSZAR PT, DPT, ATC Individual | Physical Therapist (Pediatrics) | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (877) 486-4140 |
| 1215608203 | ESMERALDA ARIZMENDY RBT Individual | Behavior Technician | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (877) 486-4140 |
| 1750875985 | ALEXANDRA SALAIZA Individual | Behavior Technician | 917 SHERWOOD DR STE 201 LAKE BLUFF, IL 60044 (877) 486-4140 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1396383030, enumerated in the NPI registry as an "individual" on December 12, 2019
The provider is located at 917 Sherwood Dr Ste 201 Lake Bluff, Il 60044 and the phone number is (877) 486-4140
The provider's speciality is Behavior Analyst with taxonomy code 103K00000X
The provider might be accepting Accepts: Blue Cross and Blue Shield of Illinois, Blue Cross. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on December 12, 2019. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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