Provider Demographics
NPI:1891833711
Name:JOHNSON-MIGALSKI, LEIGH (PSYD)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:
Last Name:JOHNSON-MIGALSKI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:LEIGH
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1190 W DEXTER LN
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2349
Mailing Address - Country:US
Mailing Address - Phone:773-852-4845
Mailing Address - Fax:
Practice Address - Street 1:17 N DEARBORN ST
Practice Address - Street 2:1500
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-4310
Practice Address - Country:US
Practice Address - Phone:773-852-4845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2017-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.007290103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical