Individual
SAMON SIDDIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
950 LEE ST, DES PLAINES, IL 60016-6532
(877) 486-4140
Mailing address
950 LEE ST STE 210, DES PLAINES, IL 60016-6574
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-46667
IL
106S00000X
Behavior Technician
RBT-17-43915
—
Other
Enumeration date
02/21/2018
Last updated
01/20/2025
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