Individual provider Active NPI

Michelle Gudauskas

  • Driver
  • Naperville, IL
National Provider Identifier
1891179685
Registry record updated Jul 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
G322-5527-7927 Issued in IL
Practice address
492 Blodgett CT
Naperville, IL 60565-4330
Phone
(630) 991-1967
NPI assigned
Jul 12, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X G322-5527-7927 IL Primary

Addresses

Primary practice location

492 Blodgett CT
Naperville, IL 60565-4330

Mailing address

492 Blodgett CT
Naperville, IL 60565-4330

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
G322-5527-7927ILMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1436659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436659200000",
    "number": "1891179685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "492 BLODGETT CT",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605654330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "492 BLODGETT CT",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605654330",
            "telephone_number": "630-991-1967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDAUSKAS",
        "first_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-12",
        "last_updated": "2015-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "IL",
            "license": "G322-5527-7927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2015; 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.