Provider Demographics
NPI:1699286989
Name:POEGEL, CINDY (MA, CCC-SLP/L)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:POEGEL
Suffix:
Gender:F
Credentials:MA, CCC-SLP/L
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:POEGEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC-SLP/L
Mailing Address - Street 1:906 SANDRA ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60145-8472
Mailing Address - Country:US
Mailing Address - Phone:815-543-4577
Mailing Address - Fax:
Practice Address - Street 1:2422 W MAIN ST UNIT 3A
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-1010
Practice Address - Country:US
Practice Address - Phone:630-402-2003
Practice Address - Fax:630-402-2003
Is Sole Proprietor?:No
Enumeration Date:2017-10-13
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146006757235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist