Provider Demographics
NPI:1013192129
Name:COVIAN-HERNANDEZ, CYNTHIA (PT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:COVIAN-HERNANDEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:COVIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:938 W 15TH PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-1841
Mailing Address - Country:US
Mailing Address - Phone:312-668-0084
Mailing Address - Fax:
Practice Address - Street 1:938 W 15TH PL
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1841
Practice Address - Country:US
Practice Address - Phone:312-668-0084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070012191225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist