| Peggy Wingo Ph.d., Llc | |
|
1248 American Way Libertyville IL 60048-3936 | |
| (847) 691-7533 | |
| (224) 433-6998 |
| Full Name | Peggy Wingo Ph.d., Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1248 American Way, Libertyville, Illinois |
| Authorized Official Name and Position | Peggy Wingo (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8476917533 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peggy Wingo Ph.d., Llc 1248 American Way Libertyville IL 60048-3936 Ph: (847) 691-7533 | Peggy Wingo Ph.d., Llc 1248 American Way Libertyville IL 60048-3936 Ph: (847) 691-7533 |
| NPI Number | 1649302050 |
|---|---|
| Provider Enumeration Date | 03/12/2007 |
| Last Update Date | 04/24/2017 |
| Medicare PECOS PAC ID | 1052682929 |
|---|---|
| Medicare Enrollment ID | O20170810003225 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649302050 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071-004959 (Illinois) | Primary |
| Provider Name | Peggy M Wingo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326244625 PECOS PAC ID: 0143591024 Enrollment ID: I20170810003325 |
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