Colin Brian Guibault, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146014276 Issued in IL

Practice address

1350 W Hawley St
Mundelein, IL 60060-1519

Phone

(847) 949-2200

NPI assigned

May 3, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mundelein Consol HS Dist 120

  • Local Education Agency (LEA)
  • Mundelein, IL
  • NPI 1225162506
  NPD (past)

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1942883459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 W HAWLEY ST",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600601519",
            "telephone_number": "847-949-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 W HAWLEY ST",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600601519",
            "telephone_number": "847-949-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIBAULT",
        "first_name": "COLIN",
        "middle_name": "BRIAN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146014276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Watson Good, LCSW
• Jennifer T Goss, LCPC
• Greenhouse Counseling PLLC
• Jason Greenwood, DPT
• Thomas J Greist, DDS
• Krishnamurthy Gururajan, MD
• Diana A. Guse, M.D.
• GZ Service Inc
• Emily Haley, ATC
• Jennifer M. Halvorsen, M.S.ED, L.M.T

• Speech-Language Pathologist in Mundelein, IL
• Providers in Mundelein, 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 May 3, 2021; 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.