Ivalis Anita Guajardo, MS SLP
Individual provider Active NPI Speech-Language Pathologist · Lindenhurst, IL
NPI 1003674375 · NPPES record last updated Mar 11, 2024
Key facts
- NPI
- 1003674375
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 242.007250 (IL)
- Practice address
- 1075 E Victory Dr
Lindenhurst, IL 60046-7910 - Phone
- (847) 356-4600
- NPI assigned
- Mar 11, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 242.007250 | IL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 242.007250 | IL | Yes |
Addresses
Primary practice location
1075 E Victory Dr
Lindenhurst, IL 60046-7910
Mailing address
1210 S White Oak Dr Apt 934
Waukegan, IL 60085-8353
Other providers in Lindenhurst, IL
- Richard L Goodson
- Jessica Goschy
- Michael J Granahan
- Kenneth John Groh
- Lauren Gruber
- Sarah Gurchak
- Janet Haro
- Heidi J Helgeson Donaubauer
- James George Hendrickx
- Highland Park CVS, L.L.C.
All providers in Lindenhurst, IL · Speech-Language Pathologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.