Provider Demographics
NPI:1124660337
Name:SINIGUR, CLEMENTIE (PA-C)
Entity type:Individual
Prefix:
First Name:CLEMENTIE
Middle Name:
Last Name:SINIGUR
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 ORLAND SQUARE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-6522
Mailing Address - Country:US
Mailing Address - Phone:407-780-8876
Mailing Address - Fax:
Practice Address - Street 1:60 ORLAND SQUARE DR STE 101
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-6522
Practice Address - Country:US
Practice Address - Phone:407-780-8876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085.007356363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant