Synchrony Brain Health LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SYNCHRONY BRAIN HEALTH LLC

Practice address

1560 Sherman Ave # 440
Evanston, IL 60201-4818

Phone

(866) 362-2300

Fax

(847) 869-1515

NPI assigned

Jan 16, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michelle Forrester

Title

Manager

Phone

(973) 740-0023

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jesse L. Viner, M.D.

  • Psychiatry Physician
  • Evanston, IL
  • NPI 1427150960
  Medicare reassignment NPD
• Maureen M Hagan, LMSW, LCDC

  • Clinical Social Worker
  • Spring Branch, TX
  • NPI 1043700164
  NPD
• David H Baron, M.D.

  • Psychiatry Physician
  • Hinsdale, IL
  • NPI 1689738874
  NPD (past)
• Tony S. Warfield, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Skokie, IL
  • NPI 1699420265
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1053900779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 SHERMAN AVE # 440",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 SHERMAN AVE # 440",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014818",
            "telephone_number": "866-362-2300",
            "fax_number": "847-869-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNCHRONY BRAIN HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-16",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-10",
        "status": "A",
        "authorized_official_last_name": "FORRESTER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "973-740-0023"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Chase Sylvester, M.S., ATC/L
• Symbria RX Services, LLC.
• Synapse Early Intervention P.C.
• Synapse Equip, LLC
• Synapse Pediatric Therapy PLLC
• Bohdan Syritsa, MD
• Veronica C. Szewczyk, PA-C
• Alexandra Szul
• Larissa Judy Szurek, COTA/L
• Melanie Szymanski

• Community/Behavioral Health Agency in Evanston, IL
• Providers in Evanston, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.