Healthcare Provider Details

I. General information

NPI: 1982612933
Provider Name (Legal Business Name): CARDINAL SLEEP CENTERS OF AMERICA LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 04/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3077 W JEFFERSON ST STE 210
JOLIET IL
60435
US

IV. Provider business mailing address

3077 W JEFFERSON ST STE 210
JOLIET IL
60435
US

V. Phone/Fax

Practice location:
  • Phone: 815-773-9090
  • Fax: 815-773-9099
Mailing address:
  • Phone: 815-773-9090
  • Fax: 815-773-9099

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: CONNIE POWERS
Title or Position: COO
Credential:
Phone: 815-773-9090