SYCAMORE INTEGRATED HEALTH LTD NPI 1942547229

NPI Information

NPI: 1942547229
Provider Name: SYCAMORE INTEGRATED HEALTH, LTD
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 14D2063934

Address:
920 W PRAIRIE DR STE J
SYCAMORE, IL
ZIP 60178
Phone: (815) 895-3354
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SYCAMORE INTEGRATED HEALTH, LTD is a multi-specialty clinic center in Sycamore, IL. SYCAMORE INTEGRATED HEALTH, LTD NPI is 1942547229. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

920 W PRAIRIE DR STE J
SYCAMORE, IL
ZIP 60178-123
Phone: (815) 895-3354
Fax: (815) 895-3345

The provider's authorized official is Zachary Sheedy .
The authorized official title is Owner/ Chiropractor and has the following contact phone number (815) 895-3354.

The CLIA number assigned to this NPI record is 14D2063934 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/7/2013 and was last updated on 7/5/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	111N00000X	Chiropractor		038011487	ILLINOIS	No
2	174400000X	Specialist		038011487	ILLINOIS	No
3	261QM1300X	Clinic/Center	Multi-Specialty			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	038013537	OTHER	ILLINOIS	PROVIDER LICENSE NUMBER
2	038011487	OTHER	ILLINOIS	PROVIDER LICENSE NUMBER
3	209019770	OTHER	ILLINOIS	PROVIDER LICENSE NUMBER
4	038011552	OTHER	ILLINOIS	PROVIDER LICENSE NUMBER
5	038013632	OTHER	ILLINOIS	PROVIDER LICENSE NUMBER
6	38011552	OTHER	ILLINOIS	PROVIDER LICENSE NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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