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General NPI Number Information
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NPI Number | 1902194160
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Entity Type | Organization
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Legal Business Name | HYBRID SLEEP LLC
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Dates
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Enumeration Date | 07/21/2011
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Last Update Date | 10/24/2011
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Provider Practice Location Address
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Address Line | 1901 RAYMOND DR STE 18C
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City | NORTHBROOK
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State | IL
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Zip | 60062-6724
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Country | US
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Telephone | 847-559-0776
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 RAYMOND DR STE 18C
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City | NORTHBROOK
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State | IL
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Zip | 60062-6724
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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 | MANAGER
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Name | MR. GENE YANOVSKIY
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Credential |
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Telephone | 847-559-0776
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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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