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General NPI Number Information
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NPI Number | 1710489497
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Entity Type | Organization
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Legal Business Name | ADVANCED CENTER FOR SLEEP DISORDERS LLC
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Dates
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Enumeration Date | 03/08/2018
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Last Update Date | 03/08/2018
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Provider Practice Location Address
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Address Line | 2500 S HIGHLAND AVE
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City | LOMBARD
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State | IL
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Zip | 60148-5363
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Country | US
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Telephone | 630-495-9826
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 S HIGHLAND AVE STE 325
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City | LOMBARD
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State | IL
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Zip | 60148-5390
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | ANJANA NAIR
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Credential | MD
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Telephone | 630-495-9826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 036125798
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License Number State | IL
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