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
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
Mailing address
7672 State Route 154 Lot 609
Du Quoin, IL 62832-3462
Registry dates
- Enumerated
- 2026-04-21
- Last updated
- 2026-04-21
- Certified
- 2026-04-21
Frequently asked questions
- 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.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.