Provider Demographics
NPI:1518235043
Name:SY HEALTH REHAB LLC
Entity Type:Organization
Organization Name:SY HEALTH REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNTO
Authorized Official - Middle Name:
Authorized Official - Last Name:YEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-344-1422
Mailing Address - Street 1:9865 W ROOSEVELT RD
Mailing Address - Street 2:105
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-2767
Mailing Address - Country:US
Mailing Address - Phone:708-344-1422
Mailing Address - Fax:708-344-1481
Practice Address - Street 1:9865 W ROOSEVELT RD
Practice Address - Street 2:105
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-2767
Practice Address - Country:US
Practice Address - Phone:708-344-1422
Practice Address - Fax:708-344-1481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-12
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360993922081P2900X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
6720480001Medicare NSC