Provider Demographics
NPI:1184854085
Name:LMG THERAPY, INC.
Entity Type:Organization
Organization Name:LMG THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPEECH LANG. PATHOLOGY
Authorized Official - Prefix:
Authorized Official - First Name:LEYNN
Authorized Official - Middle Name:MEYNCKE
Authorized Official - Last Name:GRIGAS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP/L
Authorized Official - Phone:765-491-2778
Mailing Address - Street 1:16330 CAGWIN DR
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-4741
Mailing Address - Country:US
Mailing Address - Phone:765-491-2778
Mailing Address - Fax:815-524-3194
Practice Address - Street 1:16330 CAGWIN DR
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60441-4741
Practice Address - Country:US
Practice Address - Phone:765-491-2778
Practice Address - Fax:815-524-3194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.009061235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty