Synergy Healthcare Physical Medicine SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-074050 Issued in IL

Legal business name

SYNERGY HEALTHCARE PHYSICAL MEDICINE SC

Practice address

350 Cimmeron Drive
East Peoria, IL 61611

Phone

(309) 688-4484

Fax

(309) 688-4485

NPI assigned

Oct 16, 2012

Last updated

Sep 21, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Christina D Durbin, DCNPI 1154486983

Title

Owner

Phone

(309) 688-4484

Specialties & licenses 2

Addresses

Other names 1

• Synergy Healthcare Physical Medicine Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christina D Durbin, DC

  • Chiropractor
  • East Peoria, IL
  • NPI 1154486983
  NPD Authorized official

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442793600000",
    "number": "1730432675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 CIMMERON DRIVE",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "61611",
            "telephone_number": "309-688-4484",
            "fax_number": "309-688-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 CIMMERON DRIVE",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "61611",
            "telephone_number": "309-688-4484",
            "fax_number": "309-688-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY HEALTHCARE PHYSICAL MEDICINE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-16",
        "last_updated": "2015-09-21",
        "status": "A",
        "authorized_official_last_name": "DURBIN",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-688-4484",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-008925",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-074050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Synergy Healthcare Physical Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jessica Storck, LPC
• Anna Streenz, PT
• Jacque Lynn Sutton
• Kelcy Irene Suydam, MS
• Synergy Healthcare Physical Medicine
• Tazewell County Resource Centers Inc (TCRC Sight Center)
• Tazewell Physical Medicine SC
• Tazwood Mental Health Center, Inc.
• Tazwood Mental Health Center, Inc. (Tazwood Center for Wellness)
• Tazwood Mental Health Center, Inc.

• Family Medicine Physician in East Peoria, IL
• Providers in East Peoria, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; 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.