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General NPI Number Information
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NPI Number | 1871510305
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Entity Type | Organization
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Legal Business Name | MIDWEST SLEEP ASSOCIATES, LLC
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2088 OGDEN AVE SUITE 260
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City | AURORA
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State | IL
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Zip | 60504-4376
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Country | US
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Telephone | 630-375-9499
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Fax |
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Provider Business Mailing Address
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Address Line | 2088 OGDEN AVE SUITE 260
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City | AURORA
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State | IL
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Zip | 60504-4376
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Country | US
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Telephone | 630-375-9499
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. DANA BALICKI
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Credential |
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Telephone | 630-499-6682
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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 | IL
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