Provider Demographics
NPI:1033948674
Name:SIGMA INNOVATION GROUP PLLC
Entity type:Organization
Organization Name:SIGMA INNOVATION GROUP PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEIHLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-343-4108
Mailing Address - Street 1:20558 E 1400TH AVE
Mailing Address - Street 2:
Mailing Address - City:TEUTOPOLIS
Mailing Address - State:IL
Mailing Address - Zip Code:62467-3644
Mailing Address - Country:US
Mailing Address - Phone:217-343-4108
Mailing Address - Fax:615-628-0823
Practice Address - Street 1:20558 E 1400TH AVE
Practice Address - Street 2:
Practice Address - City:TEUTOPOLIS
Practice Address - State:IL
Practice Address - Zip Code:62467-3644
Practice Address - Country:US
Practice Address - Phone:217-343-4108
Practice Address - Fax:615-628-0823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Single Specialty