Provider Demographics
NPI:1871922047
Name:BOYLE, KAREN (BCBA)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:BOYLE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 S MITCHELL AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-1805
Mailing Address - Country:US
Mailing Address - Phone:847-809-2247
Mailing Address - Fax:
Practice Address - Street 1:109 S MITCHELL AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON HTS
Practice Address - State:IL
Practice Address - Zip Code:60005-1805
Practice Address - Country:US
Practice Address - Phone:847-809-2247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-13-14593103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst