Individual
MADDOX NIEBAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., BCBA
Contact information
Practice address
1860 W WINCHESTER RD STE 108, LIBERTYVILLE, IL 60048-5312
(847) 573-9486
(847) 549-6139
Mailing address
1860 W WINCHESTER RD STE 108, LIBERTYVILLE, IL 60048-5312
(847) 549-6139
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-62337
IL
103K00000X
Behavior Analyst
152.001310
IL
Other
Enumeration date
04/12/2021
Last updated
05/05/2025
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