Provider Demographics
NPI:1245713338
Name:SURGICAL SLEEP SPECIALIST, INC
Entity type:Organization
Organization Name:SURGICAL SLEEP SPECIALIST, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-961-3875
Mailing Address - Street 1:306 W MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3227
Mailing Address - Country:US
Mailing Address - Phone:312-961-3875
Mailing Address - Fax:708-364-0269
Practice Address - Street 1:306 W MAPLE ST
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3227
Practice Address - Country:US
Practice Address - Phone:312-961-3875
Practice Address - Fax:708-364-0269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep MedicineGroup - Single Specialty