Provider Demographics
NPI:1306419296
Name:DEAGMAN, MARGARET
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:DEAGMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 E CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:IL
Mailing Address - Zip Code:61856-1446
Mailing Address - Country:US
Mailing Address - Phone:217-621-1185
Mailing Address - Fax:
Practice Address - Street 1:601 N MORGAN ST
Practice Address - Street 2:
Practice Address - City:BEMENT
Practice Address - State:IL
Practice Address - Zip Code:61813-1046
Practice Address - Country:US
Practice Address - Phone:217-678-2191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant