MEDICARE: SYNERGY WELLNESS CHIROPRACTIC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	038-012753	IL

General Provider Information

NPI Number	:	1891184164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYNERGY WELLNESS CHIROPRACTIC PC

Provider Business Mailing Address
First Line	:	4256 N ARLINGTON HEIGHTS RD
Second Line	:	STE 100
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-1300
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4256 N ARLINGTON HEIGHTS RD
Second Line	:	STE 100
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-1300
Country	:	US
Telephone Number	:	847-372-5468
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHRIS GILE
Credential	:	DC
Telephone Number	:	847-372-5468

Provider Enumeration Date	:	01/09/2015
Last Update Date	:	01/09/2015

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