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General NPI Number Information
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NPI Number | 1215569702
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Entity Type | Organization
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Legal Business Name | ILLINOIS SLEEP COUNSELING PLLC
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Dates
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Enumeration Date | 02/12/2020
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Last Update Date | 01/19/2023
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Provider Practice Location Address
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Address Line | 342 JEFFERSON AVE
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City | GLENCOE
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State | IL
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Zip | 60022-1824
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Country | US
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Telephone | 401-441-2451
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Fax |
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Provider Business Mailing Address
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Address Line | 342 JEFFERSON AVE
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City | GLENCOE
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State | IL
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Zip | 60022-1824
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Country | US
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Telephone | 401-441-2451
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | CELSO TEIXEIRA
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Credential | LCPC
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Telephone | 224-707-0720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173F00000X
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Taxonomy Name | Sleep Specialist (PhD)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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