Provider Demographics
NPI:1851411581
Name:SYMMETRIX HOME HEALTHCARE, INC.
Entity Type:Organization
Organization Name:SYMMETRIX HOME HEALTHCARE, INC.
Other - Org Name:SYNERGY HOME HEALTHCARE, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:SAMANIEGO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:847-430-6771
Mailing Address - Street 1:411 BUSINESS CENTER DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-9913
Mailing Address - Country:US
Mailing Address - Phone:847-430-6771
Mailing Address - Fax:847-430-6770
Practice Address - Street 1:411 BUSINESS CENTER DRIVE
Practice Address - Street 2:SUITE 106
Practice Address - City:MT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-9913
Practice Address - Country:US
Practice Address - Phone:847-430-6771
Practice Address - Fax:847-430-6770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010659251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147994Medicare PIN