Provider Demographics
NPI:1174502868
Name:SIGLE, JOHN M (DPM)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:SIGLE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5221 S 6TH STREET RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62703-5190
Mailing Address - Country:US
Mailing Address - Phone:217-585-7910
Mailing Address - Fax:217-529-5168
Practice Address - Street 1:2921 MONTVALE DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-5359
Practice Address - Country:US
Practice Address - Phone:217-793-9600
Practice Address - Fax:217-793-9445
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005201213ES0103X, 213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016005201Medicaid
ILP00145756OtherRR MEDICARE
IL1181750001Medicare NSC
IL016005201Medicaid
ILK10382Medicare PIN