Provider Demographics
NPI:1801922018
Name:BURLINGTON NEUROLOGY AND SLEEP CLINIC, PLC
Entity type:Organization
Organization Name:BURLINGTON NEUROLOGY AND SLEEP CLINIC, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SADHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:JANI
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:319-754-4400
Mailing Address - Street 1:1225 S GEAR AVE STE 153
Mailing Address - Street 2:MERCY PLAZA
Mailing Address - City:WEST BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52655-1686
Mailing Address - Country:US
Mailing Address - Phone:319-754-4400
Mailing Address - Fax:319-754-4412
Practice Address - Street 1:1225 S GEAR AVE STE 153
Practice Address - Street 2:MERCY PLAZA
Practice Address - City:WEST BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52655-1686
Practice Address - Country:US
Practice Address - Phone:319-754-4400
Practice Address - Fax:319-754-4412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-24
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0435941Medicaid
IL211584Medicare PIN
IAI5481Medicare UPIN