Provider Demographics
NPI:1669637344
Name:SYNAPTX, LTD
Entity Type:Organization
Organization Name:SYNAPTX, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEVELOPMENTAL THERAPIST/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ISROW
Authorized Official - Suffix:
Authorized Official - Credentials:BS/PSYC, DT
Authorized Official - Phone:815-276-7786
Mailing Address - Street 1:1799 KINGS GATE LN
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-2906
Mailing Address - Country:US
Mailing Address - Phone:815-276-7786
Mailing Address - Fax:815-788-1321
Practice Address - Street 1:1799 KINGS GATE LN
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-2906
Practice Address - Country:US
Practice Address - Phone:815-276-7786
Practice Address - Fax:815-788-1321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service