MEDICARE: KALEIGH NOEL ZEIGLER MS, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	146.013766	IL

General Provider Information

NPI Number	:	1265950968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALEIGH NOEL ZEIGLER MS, CCC-SLP

Provider Business Mailing Address
First Line	:	13895 FOWLER SCHOOL RD
Second Line	:
City	:	MARION
State	:	IL
Zip	:	62959-6806
Country	:	US
Telephone Number	:	618-694-7217
Fax Number	:

Provider Business Practice Location Address
First Line	:	3365 STATE HIGHWAY 3 NORTH
Second Line	:
City	:	WOLF LAKE
State	:	IL
Zip	:	62998
Country	:	US
Telephone Number	:	618-833-5709
Fax Number	:	618-833-4171

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2017
Last Update Date	:	09/01/2017

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