Provider Demographics
NPI:1609882422
Name:SYNERGOS P.C.
Entity Type:Organization
Organization Name:SYNERGOS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAKSHMI
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-782-8247
Mailing Address - Street 1:360 N MICHIGAN AVE STE 902
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-3803
Mailing Address - Country:US
Mailing Address - Phone:312-782-8247
Mailing Address - Fax:312-482-8247
Practice Address - Street 1:360 N MICHIGAN AVE STE 902
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-3803
Practice Address - Country:US
Practice Address - Phone:312-782-8247
Practice Address - Fax:312-482-8247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL203504Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER