Provider Demographics
NPI:1245562305
Name:ZEGLIS, CINDY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CINDY
Middle Name:
Last Name:ZEGLIS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 S POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-5560
Mailing Address - Country:US
Mailing Address - Phone:815-937-0677
Mailing Address - Fax:
Practice Address - Street 1:1240 S POPLAR AVE
Practice Address - Street 2:
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-5560
Practice Address - Country:US
Practice Address - Phone:815-937-0677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071005289103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical