Provider Demographics
NPI:1164726410
Name:THE SLEEP SOURCE LLC
Entity Type:Organization
Organization Name:THE SLEEP SOURCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLBORN-MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-971-9920
Mailing Address - Street 1:231 N ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1452
Mailing Address - Country:US
Mailing Address - Phone:630-971-9920
Mailing Address - Fax:866-810-4043
Practice Address - Street 1:231 N ADAMS ST
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-1452
Practice Address - Country:US
Practice Address - Phone:630-971-9920
Practice Address - Fax:866-810-4043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment