Provider Demographics
NPI:1881746311
Name:MASTBROOK, CYNTHIA H (DO)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:H
Last Name:MASTBROOK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:CYNTHIA
Other - Middle Name:L
Other - Last Name:GARVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:12251 S 80TH AVE
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1290
Mailing Address - Country:US
Mailing Address - Phone:708-923-3936
Mailing Address - Fax:708-923-8848
Practice Address - Street 1:12251 S 80TH AVE
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1290
Practice Address - Country:US
Practice Address - Phone:708-923-3936
Practice Address - Fax:708-923-8848
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-088690207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology