Individual provider Active NPI

Laura M Guengerich

  • Speech-Language Pathologist
  • Evanston, IL
National Provider Identifier
1255476768
Registry record updated Oct 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242.000450 Issued in IL
Practice address
1144 Maple Ave
2
Evanston, IL 60202-4208
Phone
(224) 392-6117
Fax
(224) 392-6117
NPI assigned
Feb 21, 2007
Last updated
Oct 23, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 242.000450 IL Primary

Addresses

Primary practice location

1144 Maple Ave
2
Evanston, IL 60202-4208

Mailing address

1144 Maple Ave
2
Evanston, IL 60202-4208
Phone (224) 392-6117

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

State licenses

LicenseStateTypeSpecialty
242.000450ILMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224720000000",
    "number": "1255476768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 MAPLE AVE",
            "address_2": "2",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602024208",
            "telephone_number": "224-392-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 MAPLE AVE",
            "address_2": "2",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602024208",
            "telephone_number": "224-392-6117",
            "fax_number": "224-392-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUENGERICH",
        "first_name": "LAURA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.000450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; 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.