Provider Demographics
NPI:1689106387
Name:SLEEP APNEA CARE AND WELLNESS, LLC
Entity Type:Organization
Organization Name:SLEEP APNEA CARE AND WELLNESS, LLC
Other - Org Name:KOALA CENTER FOR SLEEP DISORDERS WI-4
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:BARR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:715-341-5001
Mailing Address - Street 1:11825 STATE ROUTE 40
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DUNLAP
Mailing Address - State:IL
Mailing Address - Zip Code:61525-8842
Mailing Address - Country:US
Mailing Address - Phone:309-839-9941
Mailing Address - Fax:309-807-3365
Practice Address - Street 1:2020 COUNTY ROAD HH
Practice Address - Street 2:
Practice Address - City:PLOVER
Practice Address - State:WI
Practice Address - Zip Code:54467-2653
Practice Address - Country:US
Practice Address - Phone:715-341-5001
Practice Address - Fax:715-341-8983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-31
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3272-15122300000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No122300000XDental ProvidersDentistGroup - Single Specialty