Provider Demographics
NPI:1821344359
Name:OSWALD, SYDNEY (DPT)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:OSWALD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24196 N CONEFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:LAKE BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-1534
Mailing Address - Country:US
Mailing Address - Phone:847-370-4975
Mailing Address - Fax:
Practice Address - Street 1:24196 N CONEFLOWER DR
Practice Address - Street 2:
Practice Address - City:LAKE BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-1534
Practice Address - Country:US
Practice Address - Phone:847-370-4975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070019235225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist