Provider Demographics
NPI:1639947518
Name:SWANIGAN, ALINDA DYESHIA
Entity Type:Individual
Prefix:DR
First Name:ALINDA
Middle Name:DYESHIA
Last Name:SWANIGAN
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 1:4316 177TH ST
Mailing Address - Street 2:
Mailing Address - City:COUNTRY CLUB HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60478-4704
Mailing Address - Country:US
Mailing Address - Phone:708-224-1413
Mailing Address - Fax:
Practice Address - Street 1:4316 177TH ST
Practice Address - Street 2:
Practice Address - City:COUNTRY CLUB HILLS
Practice Address - State:IL
Practice Address - Zip Code:60478-4704
Practice Address - Country:US
Practice Address - Phone:708-224-1413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health