Provider Demographics
NPI:1386044402
Name:CYBERVYNE LLC
Entity Type:Organization
Organization Name:CYBERVYNE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-525-5388
Mailing Address - Street 1:5215 OLD ORCHARD RD
Mailing Address - Street 2:SUIT 950
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1035
Mailing Address - Country:US
Mailing Address - Phone:847-425-1760
Mailing Address - Fax:
Practice Address - Street 1:5215 OLD ORCHARD RD
Practice Address - Street 2:SUIT 950
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1035
Practice Address - Country:US
Practice Address - Phone:847-425-1760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health