Healthcare Provider Details

I. General information

NPI: 1588850150
Provider Name (Legal Business Name): WISCONSIN SLEEP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 RESEARCH PARK BLVD
MADISON WI
53719-1176
US

IV. Provider business mailing address

7974 UW HEALTH COURT
MIDDLETON WI
53562-5531
US

V. Phone/Fax

Practice location:
  • Phone: 608-232-3301
  • Fax: 608-236-4521
Mailing address:
  • Phone: 608-829-5485
  • Fax: 608-833-9201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROBERT FLANNERY
Title or Position: VP, FINANCE ADMINISTRATION
Credential:
Phone: 608-821-4223