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General NPI Number Information
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NPI Number | 1861536393
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Entity Type | Organization
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Legal Business Name | SYNERGY INSTITUTE SC
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Dates
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Enumeration Date | 02/17/2007
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Last Update Date | 01/09/2013
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Provider Practice Location Address
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Address Line | 4931 S ROUTE 59 UNIT 121
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City | NAPERVILLE
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State | IL
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Zip | 60564-5705
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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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Provider Business Mailing Address
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Address Line | 4931 S ROUTE 59 UNIT 121
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City | NAPERVILLE
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State | IL
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Zip | 60564-5705
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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 L. WISE
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Credential | DC
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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 | 038009021
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038-009021
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License Number State | IL
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