Healthcare Provider Details

I. General information

NPI: 1356229116
Provider Name (Legal Business Name): CYNTHIA MUMANI DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1658 N MILWAUKEE AVE STE C
CHICAGO IL
60647-5652
US

IV. Provider business mailing address

1658 N MILWAUKEE AVE STE C
CHICAGO IL
60647-5652
US

V. Phone/Fax

Practice location:
  • Phone: 773-355-2812
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number070.026388
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number070.026388
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number070.026388
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.026388
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: