MEDICARE: SLEEP BETTER ILLINOIS 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	332BC3200X	Customized Equipment (DME)
2	122300000X	Dentist	019022088	IL

General Provider Information

NPI Number	:	1285123349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLEEP BETTER ILLINOIS LLC

Provider Business Mailing Address
First Line	:	261 N RANDALL RD STE 103
Second Line	:
City	:	LAKE IN THE HILLS
State	:	IL
Zip	:	60156-5999
Country	:	US
Telephone Number	:	847-558-2224
Fax Number	:

Provider Business Practice Location Address
First Line	:	261 N RANDALL RD STE 103
Second Line	:
City	:	LAKE IN THE HILLS
State	:	IL
Zip	:	60156-5999
Country	:	US
Telephone Number	:	847-558-2224
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	TIM STIRNEMAN
Credential	:	DDS
Telephone Number	:	847-558-2224

Provider Enumeration Date	:	05/04/2018
Last Update Date	:	08/26/2020

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