Provider Demographics
NPI:1326711623
Name:ESPINOSA, CYNTHIA (OTR/L)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:ROMERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 HIGHPOINT DR APT 204
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-4803
Mailing Address - Country:US
Mailing Address - Phone:630-696-2331
Mailing Address - Fax:
Practice Address - Street 1:1301 W COSSITT AVE
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525-2145
Practice Address - Country:US
Practice Address - Phone:708-354-5730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-01
Last Update Date:2021-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.014011225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist