Provider Demographics
NPI:1043665730
Name:SIGL, ANTONIA JILL (MD)
Entity type:Individual
Prefix:
First Name:ANTONIA
Middle Name:JILL
Last Name:SIGL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANTONIA
Other - Middle Name:JILL
Other - Last Name:JACOB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4435 RONALD REAGAN BLVD
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80534-6409
Mailing Address - Country:US
Mailing Address - Phone:970-619-8139
Mailing Address - Fax:
Practice Address - Street 1:4435 RONALD REAGAN BLVD
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:CO
Practice Address - Zip Code:80534-6409
Practice Address - Country:US
Practice Address - Phone:970-619-8139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-29
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0062379208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics