Provider Demographics
NPI:1174659387
Name:MIDWEST NEUROSCIENCE CENTER, PLC
Entity Type:Organization
Organization Name:MIDWEST NEUROSCIENCE CENTER, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SADHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:JANI
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:319-754-7271
Mailing Address - Street 1:2500 GNAHN ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-4416
Mailing Address - Country:US
Mailing Address - Phone:319-754-7271
Mailing Address - Fax:
Practice Address - Street 1:527 PARK LN
Practice Address - Street 2:SUITE 400
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5236
Practice Address - Country:US
Practice Address - Phone:319-754-7271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-24
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Single Specialty