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General NPI Number Information
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NPI Number | 1902962350
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Entity Type | Organization
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Legal Business Name | SLEEP AND BEHAVIOR MEDICINE INSTITUTE
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 05/13/2013
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Provider Practice Location Address
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Address Line | 565 LAKEVIEW PARKWAY SUITE 105
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City | VERNON HILLS
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State | IL
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Zip | 60061-1840
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Country | US
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Telephone | 847-984-6585
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Fax | 847-984-6586
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Provider Business Mailing Address
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Address Line | 565 LAKEVIEW PARKWAY SUITE 105
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City | VERNON HILLS
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State | IL
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Zip | 60061-1840
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Country | US
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Telephone | 847-984-6585
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Fax | 847-984-6586
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MR. ALEXANDER Z GOLBIN
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Credential | MD
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Telephone | 847-984-6585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036067800
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number | 036-067800
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License Number State | IL
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