Jack Kelly, BCBA
Jack Kelly is a Behavior Analyst provider (Behavior Analyst) practicing in Lake Bluff, IL, registered in the NPPES registry with NPI 1396383030 since 2019.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1396383030 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Jack Kelly |
| Credential | BCBA |
| Sex | Male |
| Practice address | 917 SHERWOOD DR STE 201, Lake Bluff, IL, 60044 |
| Phone | 8774864140 |
| Enumeration date | 2019-12-12 |
| Last updated in NPPES | 2021-08-12 |
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 106E00000X | Assistant Behavior Analyst | Secondary | — | — |
| 103K00000X | Behavior Analyst | Primary | 1-20-45283 | IL |
Copy-ready billing details
Provider: Jack Kelly, BCBA NPI: 1396383030 Taxonomy: 103K00000X (Behavior Analyst) Address: 917 SHERWOOD DR STE 201, Lake Bluff, IL, 60044
Other providers at this practice address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1396130977 | Amie Kramp | Individual | Occupational Therapist | Lake Bluff, IL |
| 1245760099 | Meghan Verdico | Individual | Speech-Language Pathologist | Lake Bluff, IL |
| 1346744380 | Ronit Nissim | Individual | Professional Counselor | Lake Bluff, IL |
| 1750875985 | Alexandra Salaiza | Individual | Behavior Technician | Lake Bluff, IL |
| 1326518044 | Abigail Girgis | Individual | Behavior Technician | Lake Bluff, IL |
| 1093287344 | Wanda Cintron | Individual | School Social Worker | Lake Bluff, IL |
| 1669944674 | Rachael Girmscheid | Individual | Behavior Technician | Lake Bluff, IL |
| 1518421528 | Kaitlyn Desimone | Individual | Social Worker | Lake Bluff, IL |
Verify this record
Cross-check NPI 1396383030 against the authoritative CMS record: view Jack Kelly on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is the NPI number for Jack Kelly?
Where does Jack Kelly practice?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2021-08-12.