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General NPI Number Information
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NPI Number | 1891817698
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Entity Type | Organization
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Legal Business Name | ILLIANA SLEEP CENTER INC
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 01/29/2008
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Provider Practice Location Address
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Address Line | 310 N HAMMES AVE
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City | JOLIET
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State | IL
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Zip | 60435-8118
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Country | US
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Telephone | 815-730-4950
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Fax | 815-730-4951
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Provider Business Mailing Address
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Address Line | 310 N HAMMES AVE LL5
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City | JOLIET
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State | IL
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Zip | 60435-8118
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Country | US
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Telephone | 815-730-4950
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Fax | 815-730-4951
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WILBUR MILONS
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Credential |
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Telephone | 815-730-4950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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