Provider Demographics
NPI:1629208194
Name:SIEGMAN, MICHELLE LYNNE (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:LYNNE
Last Name:SIEGMAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 WHISTLER RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-5955
Mailing Address - Country:US
Mailing Address - Phone:312-259-5844
Mailing Address - Fax:
Practice Address - Street 1:202 WHISTLER RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-5955
Practice Address - Country:US
Practice Address - Phone:312-259-5844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-19
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0132711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical