Healthcare Provider Details

I. General information

NPI: 1568572980
Provider Name (Legal Business Name): JAMES J GUIDI PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6555 NORTH AVE
OAK PARK IL
60302-1059
US

IV. Provider business mailing address

6555 NORTH AVE
OAK PARK IL
60302-1059
US

V. Phone/Fax

Practice location:
  • Phone: 708-488-4968
  • Fax:
Mailing address:
  • Phone: 708-488-4968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071-003278
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number166-000396
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: