Provider Demographics
NPI:1588474449
Name:WRIGHT- STURGESS, MICHELLE ANTOINETTE
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:ANTOINETTE
Last Name:WRIGHT- STURGESS
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 1:16725 S PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-2960
Mailing Address - Country:US
Mailing Address - Phone:773-968-9008
Mailing Address - Fax:
Practice Address - Street 1:16725 S PARK AVE
Practice Address - Street 2:
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-2960
Practice Address - Country:US
Practice Address - Phone:773-968-9008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL114.150832104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker