Provider Demographics
NPI:1891089652
Name:SYNERGY REHABILITAION & CHIROPRACTIC
Entity Type:Organization
Organization Name:SYNERGY REHABILITAION & CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:630-452-8657
Mailing Address - Street 1:1048 OGDEN AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-2894
Mailing Address - Country:US
Mailing Address - Phone:630-322-9522
Mailing Address - Fax:630-322-9515
Practice Address - Street 1:1048 OGDEN AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2894
Practice Address - Country:US
Practice Address - Phone:630-322-9522
Practice Address - Fax:630-322-9515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-08
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011758111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty