Organization Active NPI

Cynthia a Sink DPM Facfas SC

  • Primary Podiatric Medicine Podiatrist
  • Orland Park, IL
National Provider Identifier
1043389703
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
016-004273 Issued in IL
Legal business name
CYNTHIA A SINK DPM FACFAS SC
Practice address
10760 W 143Rd St
Ste 60
Orland Park, IL 60462-1913
Phone
(708) 301-5600
Fax
(708) 301-5602
NPI assigned
Nov 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cynthia A Sink, DPM FACFAS SCNPI 1639168503
Title
President
Phone
(708) 301-5600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213EP1101X 016-004273 IL Primary

Addresses

Primary practice location

10760 W 143Rd St
Ste 60
Orland Park, IL 60462-1913

Mailing address

10760 W 143Rd St
Ste 60
Orland Park, IL 60462-1913
Phone (708) 301-5600

Other identifiers 1

IdentifierTypeStateIssuer
016-004273OtherILLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100128000869 IL Part B Supplier - Clinic/Group Practice 4284776246 Receives reassigned benefits from 2 practitioners
Practice locations: Orland Park, IL

National Provider Directory

National Provider Directory

Locations

10760 W 143rd St
Orland Park, IL 60462

10811 W 143rd St
Ste 100
Orland Park, IL 60467
Phone (708) 460-2500

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263945600000",
    "number": "1043389703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10760 W 143RD ST",
            "address_2": "STE 60",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604621913",
            "telephone_number": "708-301-5600",
            "fax_number": "708-301-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10760 W 143RD ST",
            "address_2": "STE 60",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604621913",
            "telephone_number": "708-301-5600",
            "fax_number": "708-301-5602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYNTHIA A SINK DPM FACFAS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2010-01-20",
        "status": "A",
        "authorized_official_last_name": "SINK",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-301-5600",
        "authorized_official_credential": "DPM FACFAS SC"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "IL",
            "license": "016-004273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "016-004273",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.