Provider Demographics
NPI:1093980849
Name:SYNERGY INSTITUTE
Entity Type:Organization
Organization Name:SYNERGY INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-355-8022
Mailing Address - Street 1:2011 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-1368
Mailing Address - Country:US
Mailing Address - Phone:630-355-8022
Mailing Address - Fax:630-355-8032
Practice Address - Street 1:4931 S STATE ROUTE 59
Practice Address - Street 2:UNIT 121
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-5618
Practice Address - Country:US
Practice Address - Phone:630-922-5790
Practice Address - Fax:690-922-5791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009021111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty