Healthcare Provider Details

I. General information

NPI: 1164090296
Provider Name (Legal Business Name): SHERRY L BUDZISZ M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 CHARLESTON LN
GILBERTS IL
60136-8027
US

IV. Provider business mailing address

174 CHARLESTON LN
GILBERTS IL
60136-8027
US

V. Phone/Fax

Practice location:
  • Phone: 847-796-6158
  • Fax: 847-527-6828
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: