Provider Demographics
NPI:1679327001
Name:MICHELLE P. SIERZEGA, LTD.
Entity type:Organization
Organization Name:MICHELLE P. SIERZEGA, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:SIERZEGA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:630-272-1837
Mailing Address - Street 1:2692 LONGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-3234
Mailing Address - Country:US
Mailing Address - Phone:630-272-1837
Mailing Address - Fax:
Practice Address - Street 1:4910 MAIN ST
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-3611
Practice Address - Country:US
Practice Address - Phone:708-320-1260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty