Provider Demographics
NPI:1821128398
Name:APPLEHOFF, CYNTHIA (PA-C)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:APPLEHOFF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 ROYAL BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-4719
Mailing Address - Country:US
Mailing Address - Phone:847-742-3120
Mailing Address - Fax:847-742-4021
Practice Address - Street 1:2350 ROYAL BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4719
Practice Address - Country:US
Practice Address - Phone:847-742-3120
Practice Address - Fax:847-742-4021
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085000737363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP27658Medicare UPIN
IL204877Medicare PIN