Provider Demographics
NPI:1790354769
Name:BOURBONNAIS SLEEP SOLUTIONS LLC
Entity Type:Organization
Organization Name:BOURBONNAIS SLEEP SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:H
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:815-937-4455
Mailing Address - Street 1:14 BRIARCLIFF CT
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-1601
Mailing Address - Country:US
Mailing Address - Phone:815-937-4455
Mailing Address - Fax:
Practice Address - Street 1:14 BRIARCLIFF CT
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-1601
Practice Address - Country:US
Practice Address - Phone:815-937-4455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THOMAS H GEORGE DDS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies