Funtastic Gymnastic LLC
NPI 1396078275ActiveOrganization· Behavior Analyst· Lombard, IL
Behavior Analyst in Lombard, Illinois, registered in NPPES in September 2009. The authorized official on file is Mark Jackson, Ceo.
Overview
| NPI | 1396078275 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 10, 2009 |
| Last updated in NPPES | May 10, 2025 |
| Certified by provider | May 10, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Behavior Analyst Primary | 103K00000X | — | — |
| Behavior Technician | 106S00000X | — | — |
| Physical Therapist | 225100000X | — | — |
| Occupational Therapist | 225X00000X | — | — |
| Speech-Language Pathologist | 235Z00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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