Provider Demographics
NPI:1316079882
Name:SYLVESTER, LINDA ANNE (LPT, CEAS)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:ANNE
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:LPT, CEAS
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:ANNE
Other - Last Name:SYLVESTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPT, CEAS
Mailing Address - Street 1:1524 PITNER AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-3961
Mailing Address - Country:US
Mailing Address - Phone:312-315-2459
Mailing Address - Fax:847-475-1434
Practice Address - Street 1:1524 PITNER AVE
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3961
Practice Address - Country:US
Practice Address - Phone:312-315-2459
Practice Address - Fax:847-475-1434
Is Sole Proprietor?:No
Enumeration Date:2007-03-11
Last Update Date:2012-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070004423225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9342454OtherPHCS
IL01634535OtherBLUE CROSS BLUE SHIELD
IL9342454OtherPHCS