Healthcare Provider Details

I. General information

NPI: 1316419963
Provider Name (Legal Business Name): SONAM SAYANIA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2018
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4822 S COTTAGE GROVE AVE STE 1-400
CHICAGO IL
60615
US

IV. Provider business mailing address

4822 S COTTAGE GROVE AVE STE 1-400
CHICAGO IL
60615
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-1500
  • Fax: 312-921-1171
Mailing address:
  • Phone: 630-933-1500
  • Fax: 312-921-1171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.024059
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: