MEDICARE: ST. ALEXIUS CENTER FOR SLEEP HEALTH 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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1760511810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. ALEXIUS CENTER FOR SLEEP HEALTH LLC

Provider Business Mailing Address
First Line	:	1300 S MAIN ST
Second Line	:
City	:	LOMBARD
State	:	IL
Zip	:	60148-4526
Country	:	US
Telephone Number	:	630-652-7900
Fax Number	:	630-652-7999

Provider Business Practice Location Address
First Line	:	1786 MOON LAKE BOULEVARD
Second Line	:	SUITE 214
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60169-1067
Country	:	US
Telephone Number	:	630-652-7900
Fax Number	:	630-652-7999

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. WILLIAM A STAMER
Credential	:
Telephone Number	:	630-652-7900

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	01/05/2012

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