Provider Demographics
NPI:1386516250
Name:FEBUS-FAMISARAN, JASMINE LYNNETTE
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:LYNNETTE
Last Name:FEBUS-FAMISARAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 PARK RIDGE LN UNIT C
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-6157
Mailing Address - Country:US
Mailing Address - Phone:630-881-7189
Mailing Address - Fax:
Practice Address - Street 1:1975 MC DOWELL RD STE 101
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-6533
Practice Address - Country:US
Practice Address - Phone:331-229-8839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-20
Last Update Date:2025-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician