Synergenx Health - Burr Ridge LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SYNERGENX HEALTH - BURR RIDGE LLC

Practice address

11S250 S Jackson St
#102
Burr Ridge, IL 60527-6891

Phone

(281) 970-5900

Fax

(281) 970-5913

NPI assigned

Apr 25, 2017

Organization subpart

No

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

Authorized official

Name

Welton Wayne Wilson

Title

Ceo

Phone

(281) 429-8522

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1396270674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16131 N ELDRIDGE PKWY STE 100",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773779130",
            "telephone_number": "713-204-3818",
            "fax_number": "281-970-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11S250 S JACKSON ST",
            "address_2": "#102",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276891",
            "telephone_number": "281-970-5900",
            "fax_number": "281-970-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGENX HEALTH - BURR RIDGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-25",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "WELTON",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "281-429-8522"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric C Svensson, MD
• SW Anesthesiology Limited
• Nadera J Sweiss, MD
• Mary Therese Sycip, PT
• Humzah Syed
• Noah Alexander Tadevich, DPT
• Joseph Tadros
• James Tan
• Jerome B Taxy, MD
• Terra Firma Behavioral Health

• Primary Care Clinic/Center in Burr Ridge, IL
• Providers in Burr Ridge, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.