Provider Demographics
NPI:1639168503
Name:SINK, CYNTHIA ANN (DPM FACFAS SC)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:ANN
Last Name:SINK
Suffix:
Gender:F
Credentials:DPM FACFAS SC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10760 W 143RD ST
Mailing Address - Street 2:SUITE 60
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-1915
Mailing Address - Country:US
Mailing Address - Phone:708-301-5600
Mailing Address - Fax:708-301-5602
Practice Address - Street 1:10760 W 143RD ST
Practice Address - Street 2:SUITE 60
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-1915
Practice Address - Country:US
Practice Address - Phone:708-301-5600
Practice Address - Fax:708-301-5602
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016004273213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016004273Medicaid
IL016004273Medicaid
IL200066Medicare ID - Type Unspecified
ILT87435Medicare UPIN
IL997370Medicare ID - Type Unspecified