Provider Demographics
NPI:1790836849
Name:SIGULAS, JANICE C (P T)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:C
Last Name:SIGULAS
Suffix:
Gender:F
Credentials:P T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2351 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:PEKIN
Mailing Address - State:IL
Mailing Address - Zip Code:61554-3972
Mailing Address - Country:US
Mailing Address - Phone:309-353-5940
Mailing Address - Fax:309-353-1654
Practice Address - Street 1:2351 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PEKIN
Practice Address - State:IL
Practice Address - Zip Code:61554-3972
Practice Address - Country:US
Practice Address - Phone:309-353-5940
Practice Address - Fax:309-353-1654
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070005911225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL10760553OtherCAQH PROVIDER ID
ILP00191172OtherRRMC NUMBER
ILL69888Medicare PIN