Active NPI
Cyrajean Gotladera Sy, PT, DPT
- Physical Therapist
- Arlington Heights, IL
National Provider Identifier
1366153249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.022918
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 070.022918 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehab Maxx LLC | Physical Therapist | Current | 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.