Provider Demographics
NPI:1679639819
Name:SATKO, CYNTHIA R (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:R
Last Name:SATKO
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 HILLGROVE AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WESTERN SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60558-1490
Mailing Address - Country:US
Mailing Address - Phone:708-246-6400
Mailing Address - Fax:708-246-4920
Practice Address - Street 1:800 HILLGROVE AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:WESTERN SPRINGS
Practice Address - State:IL
Practice Address - Zip Code:60558-1490
Practice Address - Country:US
Practice Address - Phone:708-246-6400
Practice Address - Fax:708-246-4920
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019018221122300000X
IL0210013241223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT38947Medicare UPIN
IL209268Medicare ID - Type UnspecifiedMEDICARE