Synergy Healthcare Physical Medicine

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085005566 Issued in IL

Legal business name

SYNERGY HEALTHCARE PHYSICAL MEDICINE

Practice address

350 Cimmeron Dr
East Peoria, IL 61611-7511

Phone

(309) 688-4484

Fax

(309) 688-4485

NPI assigned

Dec 3, 2015

Organization subpart

No

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

Authorized official

Name

Glenda Barker

Title

Billing Administrator

Phone

(309) 688-4484

Specialties & licenses 1

Addresses

Practitioners 1

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

• Christina D Durbin, DC

  • Chiropractor
  • East Peoria, IL
  • NPI 1154486983
  NPD

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

{
    "created_epoch": "1449100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449100800000",
    "number": "1841665718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 CIMMERON DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616117511",
            "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 DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616117511",
            "telephone_number": "309-688-4484",
            "fax_number": "309-688-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY HEALTHCARE PHYSICAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-03",
        "last_updated": "2015-12-03",
        "status": "A",
        "authorized_official_last_name": "BARKER",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_title_or_position": "BILLING ADMINISTRATOR",
        "authorized_official_telephone_number": "309-688-4484"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy J Stone, APRN
• Jessica Storck, LPC
• Anna Streenz, PT
• Jacque Lynn Sutton
• Kelcy Irene Suydam, MS
• Synergy Healthcare Physical Medicine SC
• Tazewell County Resource Centers Inc
• Tazewell Physical Medicine SC
• Tazwood Mental Health Center, Inc.
• Tazwood Mental Health Center, Inc.

• Physician Assistant in East Peoria, IL
• Providers in East Peoria, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.