Individual
CYNTHIA BARDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
140 E LOOP RD, WHEATON, IL 60189-8407
(312) 243-8487
Mailing address
847 STAGHORN LN APT 102, NORTH AURORA, IL 60542-1424
(815) 990-8480
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-43375
IL
106S00000X
Behavior Technician
RBT-17-46043
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UWBAN2675853
BLUECROSS BLUESHIELD
IL
Enumeration date
03/21/2018
Last updated
05/05/2021
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