Basic Information
Provider Information
NPI: 1912023128
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MONDSCHEINJANULAITIS
FirstName: CYNTHIA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: PT.MS.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2640 N AVONDALE AVE
Address2: UNIT H
City: CHICAGO
State: IL
PostalCode: 606476403
CountryCode: US
TelephoneNumber: 7733422733
FaxNumber:  
Practice Location
Address1: 1740 W TAYLOR ST
Address2: ROOM C-100
City: CHICAGO
State: IL
PostalCode: 606127232
CountryCode: US
TelephoneNumber: 3129963700
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/21/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X ILY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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