MEDICARE: TOTAL HEALTH SLEEP SOLUTIONS INC

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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1285035832
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL HEALTH SLEEP SOLUTIONS INC

Provider Business Mailing Address
First Line	:	87 S MCLEAN BLVD
Second Line	:
City	:	SOUTH ELGIN
State	:	IL
Zip	:	60177-1835
Country	:	US
Telephone Number	:	847-888-8311
Fax Number	:

Provider Business Practice Location Address
First Line	:	87 S MCLEAN BLVD
Second Line	:
City	:	SOUTH ELGIN
State	:	IL
Zip	:	60177-1835
Country	:	US
Telephone Number	:	847-888-8311
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ANTHONY R BENNARDO JR.
Credential	:	D.D.S.
Telephone Number	:	847-888-8311

Provider Enumeration Date	:	09/12/2014
Last Update Date	:	01/06/2015

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