Active NPI
Katlyn Smigielski, MED/EDS
- School Psychologist
- Bolingbrook, IL
National Provider Identifier
1104780816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 1233856
- Practice address
- 197 Winston Dr
Bolingbrook, IL 60440-1300 - Phone
- (630) 739-0185
- NPI assigned
- Dec 16, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 1233856 | IL | Primary |
Addresses
Primary practice location
197 Winston Dr
Bolingbrook, IL 60440-1300
Mailing address
11321 Sycamore LN Unit D
Palos Hills, IL 60465-2572
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1233856 | IL | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1765843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765843200000",
"number": "1104780816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11321 SYCAMORE LN UNIT D",
"city": "PALOS HILLS",
"state": "IL",
"postal_code": "604652572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "197 WINSTON DR",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604401300",
"telephone_number": "630-739-0185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMIGIELSKI",
"first_name": "KATLYN",
"credential": "MED/EDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-12-16",
"last_updated": "2025-12-16",
"certification_date": "2025-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "IL",
"license": "1233856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bolingbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.