Healthcare Provider Details

I. General information

NPI: 1548307234
Provider Name (Legal Business Name): AYELET SNOW II M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10640 W 165TH STREET
ORLAND PARK IL
60467
US

IV. Provider business mailing address

10640 W 165TH STREET
ORLAND PARK IL
60467
US

V. Phone/Fax

Practice location:
  • Phone: 708-364-0261
  • Fax: 708-364-0269
Mailing address:
  • Phone: 708-364-0261
  • Fax: 708-364-0269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License Number036-122748
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License Number40044
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: