What is Ezra Grimm's NPI number?

Ezra Grimm's National Provider Identifier (NPI) is 1104761618, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.

What is Ezra Grimm's specialty?

Ezra Grimm is listed in the NPPES registry with a primary specialty of Behavior Technician (Behavioral Health & Social Service Providers).

Where is Ezra Grimm located?

Ezra Grimm's practice location on file with NPPES is 7672 State Route 154 Lot 609, Du Quoin, IL 62832-3462.

What is Ezra Grimm's phone number?

The practice phone number listed in the NPPES registry for Ezra Grimm is (618) 542-7525.

Is Ezra Grimm's NPI active?

Yes — Ezra Grimm's NPI (1104761618) is active in the NPPES registry as of the last update on 2026-04-21.

IndividualActive

Ezra Grimm

NPI 1104761618 · Behavior Technician · Du Quoin, IL

Ezra Grimm is a Behavior Technician provider in Du Quoin, IL (NPI 1104761618).

Provider details

NPI number: 1104761618
Entity type: Individual
Primary specialty: Behavior TechnicianBehavioral Health & Social Service Providers
Sole proprietor: No

Specialties & taxonomies

Behavior TechnicianPrimary106S00000X
Behavioral Health & Social Service Providers

Profile Score

Basic profile(46/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
Under 1 yr in registry
Profile completeness38% of score
83% of core fields populated
Practice footprint23% of score
1 documented practice location

Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

Practice location

7672 State Route 154 Lot 609

Du Quoin, IL 62832-3462

Phone: (618) 542-7525

Approximate (ZIP-level) locationGet directions

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Mailing address