MEDICARE: UNIVERSAL SLEEP AND ATTENTION CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1114044401
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSAL SLEEP AND ATTENTION CENTER LLC

Provider Business Mailing Address
First Line	:	4775 MANHATTAN DR
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61108-2264
Country	:	US
Telephone Number	:	815-397-4600
Fax Number	:	815-397-4614

Provider Business Practice Location Address
First Line	:	4775 MANHATTAN DR
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61108-2264
Country	:	US
Telephone Number	:	815-397-4600
Fax Number	:	815-397-4614

Authorized Official
Title or Position	:	BUSINESS DIRECTOR
Name	:	MANNY ABALOS
Credential	:
Telephone Number	:	815-397-4600

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	03/05/2013

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