Individual
ELIZABETH E SIEGFORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC/SLP/L
Contact information
Practice address
488 SPRING DR, MARENGO, IL 60152-3311
(847) 366-8205
(815) 568-8851
Mailing address
488 SPRING DR, MARENGO, IL 60152-3311
(847) 366-8205
(815) 568-8851
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05632188
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/02/2006
Last updated
07/08/2007
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