Healthcare Provider Details

I. General information

NPI: 1780369298
Provider Name (Legal Business Name): BRIANNA MARIA GUZMAN AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 SHERMAN AVE STE 100
EVANSTON IL
60201-3711
US

IV. Provider business mailing address

1630 SHERMAN AVE STE 100
EVANSTON IL
60201-3711
US

V. Phone/Fax

Practice location:
  • Phone: 847-535-6464
  • Fax: 224-271-4870
Mailing address:
  • Phone: 847-535-6464
  • Fax: 224-271-4870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number147002050
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number23002819A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: