Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nicholas Guastalli, DO

Individual provider Internal Medicine Physician · NPI 1275957334

Nicholas Guastalli, DO is an Internal Medicine in Kankakee, Illinois. Qualified in 2014, 12 years ago. Practices with Riverside Health System, a 205-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
12
Licensed in
IL
In the registry since
2014
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

401 N Wall St Ste 102
Kankakee, IL 60901-2934
Phone: (815) 928-5090
Fax: (815) 928-5079
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 036143561 (IL)

Record details

NPI number1275957334
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedFebruary 10, 2014
Last updated in NPPESJuly 21, 2022
Certification dateMarch 22, 2021
Mailing address401 N Wall St Ste 102, Kankakee, IL 60901-2934

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Riverside Health System — 205 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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