Provider Demographics
NPI:1730267139
Name:BESTRYCKI, CINDY SUE (PA-C)
Entity type:Individual
Prefix:MS
First Name:CINDY
Middle Name:SUE
Last Name:BESTRYCKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 WINTHROP AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60139-1405
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 WINTHROP AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60139-1405
Practice Address - Country:US
Practice Address - Phone:630-980-5480
Practice Address - Fax:630-980-5485
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085001268363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP77319Medicare UPIN
K20324Medicare ID - Type Unspecified