Provider Demographics
NPI:1164412656
Name:AKS, CYNTHIA (DO)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:AKS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:AKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1239 E MAIN ST
Mailing Address - Street 2:P O BOX 3988
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62901-3114
Mailing Address - Country:US
Mailing Address - Phone:618-457-5200
Mailing Address - Fax:618-351-4821
Practice Address - Street 1:1237 E MAIN SUITE C1
Practice Address - Street 2:THE BREAST CENTER UNIVERSITY MALL
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-3114
Practice Address - Country:US
Practice Address - Phone:618-457-2281
Practice Address - Fax:618-529-0573
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICA009351208600000X
IL306126874208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4124481Medicaid
MI134360OtherCARE CHOICES
MI020044482OtherRAILROAD MEDICARE
IL036126874Medicaid
MI14797OtherMCARE
MI258213724OtherBCBS
MIHAPOtherE83433
MI020H232520OtherBCBSM
MI0P22840Medicare ID - Type Unspecified
MI020H232520OtherBCBSM
MIE83433Medicare UPIN