Provider Demographics
NPI:1558440115
Name:DRUNGLE, MARGARET ROSE (MACLINICALPSYCHOLOGY)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:ROSE
Last Name:DRUNGLE
Suffix:
Gender:F
Credentials:MACLINICALPSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 BENEDETTI DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2474
Mailing Address - Country:US
Mailing Address - Phone:630-355-8832
Mailing Address - Fax:630-355-8832
Practice Address - Street 1:445 W JACKSON AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5256
Practice Address - Country:US
Practice Address - Phone:630-430-1212
Practice Address - Fax:630-430-1212
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02232615OtherBCBS PROVIDER NUMBER