Provider Demographics
NPI:1689781940
Name:SLEEP CENTERS OF AMERICA INC
Entity Type:Organization
Organization Name:SLEEP CENTERS OF AMERICA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:MANNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-561-3700
Mailing Address - Street 1:5962 N LINCOLN AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-3711
Mailing Address - Country:US
Mailing Address - Phone:773-561-3700
Mailing Address - Fax:773-561-3723
Practice Address - Street 1:5962 N LINCOLN AVE STE 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-3711
Practice Address - Country:US
Practice Address - Phone:773-561-3700
Practice Address - Fax:773-561-3723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL=========001Medicaid