Provider Demographics
NPI:1366062929
Name:COOKE, CHRISTINE SEVCIK (PT)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:SEVCIK
Last Name:COOKE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:MARY
Other - Last Name:SEVCIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4N234 PIONEER CT
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-7730
Mailing Address - Country:US
Mailing Address - Phone:847-530-6161
Mailing Address - Fax:
Practice Address - Street 1:1619 N MILL ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2858
Practice Address - Country:US
Practice Address - Phone:630-701-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070014483225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist