Provider Demographics
NPI:1821373879
Name:SUBURBAN SLEEP AND PULMONARY MEDICINE, SC
Entity Type:Organization
Organization Name:SUBURBAN SLEEP AND PULMONARY MEDICINE, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-773-9090
Mailing Address - Street 1:3077 W JEFFERSON ST STE 210
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-5264
Mailing Address - Country:US
Mailing Address - Phone:815-773-9090
Mailing Address - Fax:815-773-9099
Practice Address - Street 1:3077 W JEFFERSON ST STE 210
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-5264
Practice Address - Country:US
Practice Address - Phone:815-773-9090
Practice Address - Fax:815-773-9099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-20
Last Update Date:2023-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036104101207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty