Provider Demographics
NPI:1154744985
Name:SINIGAL-JOHNSON, MARGUERITE
Entity type:Individual
Prefix:MRS
First Name:MARGUERITE
Middle Name:
Last Name:SINIGAL-JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4517 COLUMBINE LN
Mailing Address - Street 2:
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-1759
Mailing Address - Country:US
Mailing Address - Phone:708-220-7357
Mailing Address - Fax:
Practice Address - Street 1:19740 GOVERNORS HWY
Practice Address - Street 2:SUITE 118
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-2084
Practice Address - Country:US
Practice Address - Phone:708-799-5569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146002943235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL146002943OtherLICENSE