Provider Demographics
NPI:1831667484
Name:SEIGAL, THERESE (PA)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:
Last Name:SEIGAL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:575 TURNPIKE ST STE 21
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5937
Mailing Address - Country:US
Mailing Address - Phone:978-794-1946
Mailing Address - Fax:978-975-3925
Practice Address - Street 1:1945 W WILSON AVE STE 100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-7927
Practice Address - Country:US
Practice Address - Phone:773-769-9040
Practice Address - Fax:847-866-8990
Is Sole Proprietor?:No
Enumeration Date:2018-11-12
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MAPA6668363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant