Provider Demographics
NPI:1457425209
Name:SLEEPWATCHERS, PLLC
Entity type:Organization
Organization Name:SLEEPWATCHERS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT, PHD
Authorized Official - Phone:847-838-9253
Mailing Address - Street 1:50 S MILWAUKEE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLA
Mailing Address - State:IL
Mailing Address - Zip Code:60046-5426
Mailing Address - Country:US
Mailing Address - Phone:847-838-9253
Mailing Address - Fax:888-608-0343
Practice Address - Street 1:50 S MILWAUKEE AVE STE 201
Practice Address - Street 2:
Practice Address - City:LAKE VILLA
Practice Address - State:IL
Practice Address - Zip Code:60046-5426
Practice Address - Country:US
Practice Address - Phone:847-838-9253
Practice Address - Fax:888-608-0343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BX2000X, 173F00000X, 261QE0800X, 261QM2500X, 261QR1100X, 261QS1200X, 291U00000X
IL203-000629332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & SuppliesGroup - Multi-Specialty
No173F00000XOther Service ProvidersSleep Specialist, PhDGroup - Multi-Specialty
No261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04932063OtherDME PROVIDER #
IL=========OtherTRICARE HEALTHNET FEDERAL
IL04932063OtherDME PROVIDER #