Synergy Integrative Headache Center LTD

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

SYNERGY INTEGRATIVE HEADACHE CENTER LTD

Practice address

191 Waukegan Rd Ste 300
Northfield, IL 60093-2744

Phone

(773) 948-7557

NPI assigned

Jun 16, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Alexander Feoktistov, MDNPI 1003143801

Title

President

Phone

(773) 729-0835

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22631/brand/1/csg/1/fhir/r4

Practitioners 3

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

• Alexander Feoktistov, MD

  • Interventional Pain Medicine Physician
  • Northfield, IL
  • NPI 1003143801
  Medicare reassignment NPD Authorized official
• Jessica Horwitz

  • Family Nurse Practitioner
  • Chicago, IL
  • NPI 1649758426
  Medicare reassignment NPD
• Lindsay Chick Sloan, PA-C

  • Physician Assistant
  • Chicago, IL
  • NPI 1972046860
  Medicare reassignment

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599004800000",
    "number": "1568087583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 WAUKEGAN RD STE 300",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600932744",
            "telephone_number": "773-948-7557",
            "fax_number": "773-948-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 WAUKEGAN RD STE 300",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600932744",
            "telephone_number": "773-948-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY INTEGRATIVE HEADACHE CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A",
        "authorized_official_last_name": "FEOKTISTOV",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-729-0835",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Sutherland, LSW
• Rachel Swanson, LCSW
• Jacqueline Swietochowski
• Symbria Rehab, Inc.
• Synapse and Soma Mental Health PLLC
• Roxxy Shyanna Tafoya
• Kathleen Tarro, PTA
• Marquis Taylor
• Jesus Tejeda, MASTERS DEGREE
• Telemedico Physicians Nephrology S.C

• Pain Medicine Physician in Northfield, IL
• Providers in Northfield, IL by specialty
• Pain Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; 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.