Provider Demographics
NPI:1831206796
Name:STIEFBOLD, MARGUERITE MARY (EDD)
Entity type:Individual
Prefix:DR
First Name:MARGUERITE
Middle Name:MARY
Last Name:STIEFBOLD
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 COURTNEY CIR
Mailing Address - Street 2:
Mailing Address - City:SUGAR GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60554-9261
Mailing Address - Country:US
Mailing Address - Phone:630-466-0573
Mailing Address - Fax:630-466-0573
Practice Address - Street 1:441 COURTNEY CIR
Practice Address - Street 2:
Practice Address - City:SUGAR GROVE
Practice Address - State:IL
Practice Address - Zip Code:60554-9261
Practice Address - Country:US
Practice Address - Phone:630-466-0862
Practice Address - Fax:630-466-0862
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist