| Doctor Name: | MICHAEL EDWARD UPSHAW |
| NPI Number: | 1063673978 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | SLP |
| License Number: | 2202005513 |
| Business Practice Address: | 820 W Sunnyside Ave Apt 3a Chicago, IL - 606406179 |
| Business Phone Number: | 3122869903 |
| Business Fax Number: | |
| Mailing Address: | 820 W Sunnyside Ave Apt 3a, CHICAGO |
| State: | IL |
| Postal Code: | 606406179 |
| Phone Number: | 3122869903 |
| Fax Number: | |
| NPI Enumeration Date: | 06/23/2008 |
| NPI Last Update Date: | 07/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2202005513 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |