MEDICARE: SLEEP CENTERS OF AMERICA 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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1689781940
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLEEP CENTERS OF AMERICA INC

Provider Business Mailing Address
First Line	:	5962 N LINCOLN AVE STE 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-3711
Country	:	US
Telephone Number	:	773-561-3700
Fax Number	:	773-561-3723

Provider Business Practice Location Address
First Line	:	5962 N LINCOLN AVE STE 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-3711
Country	:	US
Telephone Number	:	773-561-3700
Fax Number	:	773-561-3723

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MOHAMMAD A MANNAN
Credential	:
Telephone Number	:	773-561-3700

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	04/20/2008

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Directions to “SLEEP CENTERS OF AMERICA INC ” Practice Location

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