Michael Edward Upshaw, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.009753 Issued in IL

Practice address

820 W Sunnyside Ave Apt 3a
Chicago, IL 60640-6179

Phone

(312) 286-9903

NPI assigned

Jun 23, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311206400000",
    "number": "1063673978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 W SUNNYSIDE AVE APT 3A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606406179",
            "telephone_number": "312-286-9903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 W SUNNYSIDE AVE APT 3A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606406179",
            "telephone_number": "312-286-9903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPSHAW",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2011-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202005513",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.009753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004909976",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.