Provider Demographics
NPI:1629473558
Name:WELLTRINSIC SLEEP NETWORK, INC.
Entity Type:Organization
Organization Name:WELLTRINSIC SLEEP NETWORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:331-481-4700
Mailing Address - Street 1:2510 N FRONTAGE RD
Mailing Address - Street 2:STE 201
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-1511
Mailing Address - Country:US
Mailing Address - Phone:331-481-4700
Mailing Address - Fax:
Practice Address - Street 1:2510 N FRONTAGE RD
Practice Address - Street 2:STE 201
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-1511
Practice Address - Country:US
Practice Address - Phone:331-481-4700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization