Individual provider Active NPI

Cyrajean Gotladera Sy, PT, DPT

  • Physical Therapist
  • Arlington Heights, IL
National Provider Identifier
1366153249
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.022918 Issued in IL
Practice address
415 W Golf Rd Ste 52
Arlington Heights, IL 60005-3923
Phone
(847) 258-5420
NPI assigned
Dec 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.022918 IL Primary

Addresses

Primary practice location

415 W Golf Rd Ste 52
Arlington Heights, IL 60005-3923

Mailing address

415 W Golf Rd Ste 52
Arlington Heights, IL 60005-3923
Phone (847) 258-5420

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230227002690 IL Practitioner - Physical Therapist in Private Practice 8628441383 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.022918ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Maxx LLC Physical Therapist CurrentSince Jan 1, 2023 Accepting new patients

Locations

415 W Golf Rd
Ste 52
Arlington Hts, IL 60005
Phone (847) 258-5420

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1366153249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W GOLF RD STE 52",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600053923",
            "telephone_number": "847-258-5420",
            "fax_number": "847-258-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W GOLF RD STE 52",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600053923",
            "telephone_number": "847-258-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SY",
        "first_name": "CYRAJEAN",
        "middle_name": "GOTLADERA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.022918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.