Provider Demographics
NPI:1306132352
Name:SORLIE, CINDY I (DPT)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:I
Last Name:SORLIE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:I
Other - Last Name:CARAOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:33900 HARPER AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:586-350-2644
Mailing Address - Fax:
Practice Address - Street 1:365 S RANDALL RD
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-5526
Practice Address - Country:US
Practice Address - Phone:847-930-5950
Practice Address - Fax:847-930-5951
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070018526225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP01393865OtherRR MEDICARE
ILP00993027OtherMCRR
ILP00993027OtherMCRR
ILP01393865OtherRR MEDICARE
ILIL2993019Medicare PIN