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General NPI Number Information
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NPI Number | 1114158557
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Entity Type | Organization
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Legal Business Name | SYNERGY INSTITUTE S.C.
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Dates
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Enumeration Date | 08/03/2009
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Last Update Date | 08/03/2009
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Provider Practice Location Address
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Address Line | 601 W NORRIS DR SUITE B
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City | OTTAWA
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State | IL
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Zip | 61350-1381
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Country | US
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Telephone | 815-431-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 2011 S WASHINGTON ST
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City | NAPERVILLE
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State | IL
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Zip | 60565-1368
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Country | US
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Telephone | 630-355-8022
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Fax | 630-355-8032
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Authorized Official
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Title or Position | OWNER
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Name | DR. JENNIFER WISE
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Credential | D.C.
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Telephone | 630-355-8022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 042.617777
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License Number State | IL
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