Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blue Bolt Pediatric Care

Organization Behavior Analyst · NPI 1093551350

Blue Bolt Pediatric Care is a Behavior Analyst in Evanston, Illinois. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
2

Practice location Address checks out

800 Elgin Rd Apt 1218
Evanston, IL 60201-5628
Phone: (917) 580-2599
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X
Community/Behavioral Health Agency Taxonomy 251S00000X

Record details

NPI number1093551350
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Emily Groben — Board Certified Behavior Analyst · (917) 580-2599
NPI enumeratedJuly 6, 2024
Last updated in NPPESApril 4, 2025
Certification dateApril 4, 2025
Mailing address1555 Sherman Ave # 324, Evanston, IL 60201-4421

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