Healthcare Provider Details

I. General information

NPI: 1255400735
Provider Name (Legal Business Name): ALTERNATIVE SLEEP DISORDERS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 N MAIN ST
ALGONQUIN IL
60102-3482
US

IV. Provider business mailing address

1122 N MAIN ST
ALGONQUIN IL
60102-3482
US

V. Phone/Fax

Practice location:
  • Phone: 847-854-7250
  • Fax: 847-854-7252
Mailing address:
  • Phone: 847-854-7250
  • Fax: 847-854-7252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. BENJAMIN JAY NAGER
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 847-854-7250