Michael J Guidotti, M.S., CCC-SLP/L

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.014791 Issued in IL

Practice address

850 Dunham Rd
St Charles, IL 60174-1494

Phone

(630) 443-4400

NPI assigned

Sep 4, 2018

Last updated

Aug 4, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1629550959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 BURNING TREE LN",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632411",
            "telephone_number": "815-409-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 DUNHAM RD",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741494",
            "telephone_number": "630-443-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 N Cass Ave Ste 311",
            "address_purpose": "LOCATION",
            "city": "Westmont",
            "state": "IL",
            "postal_code": "605596403",
            "country_code": "US",
            "telephone_number": "708-533-1543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUIDOTTI",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "M.S., CCC-SLP/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-04",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.004992",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.014791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION",
            "identifier": "146.014791",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Westmont",
            "affiliation": "N",
            "address_1": "825 N Cass Ave Ste 311",
            "city": "Westmont",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605596403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Speech-Language Pathologist in St Charles, IL
• Providers in St Charles, 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 Aug 4, 2020; 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.