Provider Demographics
NPI:1518684489
Name:BIGOS, ISABELLA MARIE
Entity Type:Individual
Prefix:MRS
First Name:ISABELLA
Middle Name:MARIE
Last Name:BIGOS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ISABELLA
Other - Middle Name:MARIE
Other - Last Name:10212022503207
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15731 CHAPEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-5954
Mailing Address - Country:US
Mailing Address - Phone:708-203-0142
Mailing Address - Fax:
Practice Address - Street 1:1343 EAST 7TH STREET
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60441
Practice Address - Country:US
Practice Address - Phone:815-838-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-21
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.006931235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist