MEDICARE: DR. JAMES J GUIDI PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	071-003278	IL
2	106H00000X	Marriage & Family Therapist	166-000396	IL

General Provider Information

NPI Number	:	1568572980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES J GUIDI PSY.D.

Provider Business Mailing Address
First Line	:	6555 NORTH AVE
Second Line	:
City	:	OAK PARK
State	:	IL
Zip	:	60302-1059
Country	:	US
Telephone Number	:	708-488-4968
Fax Number	:

Provider Business Practice Location Address
First Line	:	6555 NORTH AVE
Second Line	:
City	:	OAK PARK
State	:	IL
Zip	:	60302-1059
Country	:	US
Telephone Number	:	708-488-4968
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	08/10/2009

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