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General NPI Number Information
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NPI Number | 1487495826
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Entity Type | Organization
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Legal Business Name | REM SLEEP LAB
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Dates
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Enumeration Date | 05/31/2024
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 17920 SAINT ROSE RD APT A
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City | BREESE
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State | IL
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Zip | 62230-2513
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Country | US
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Telephone | 618-882-8955
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Fax |
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Provider Business Mailing Address
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Address Line | 10850 LINCOLN TRL UNIT 16
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City | FAIRVIEW HEIGHTS
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State | IL
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Zip | 62208-2026
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Country | US
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Telephone | 618-882-8955
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBYN ALBERS
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Credential | CRT-RPSGT
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Telephone | 618-882-8955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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