Provider Demographics
NPI:1841043130
Name:ASSOCIATES FOR DENTAL SLEEP MEDICINE, LTD
Entity type:Organization
Organization Name:ASSOCIATES FOR DENTAL SLEEP MEDICINE, LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VALCARENGHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-834-8088
Mailing Address - Street 1:360 W BUTTERFIELD RD STE 230
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5000
Mailing Address - Country:US
Mailing Address - Phone:847-847-5337
Mailing Address - Fax:630-834-8091
Practice Address - Street 1:360 W BUTTERFIELD RD STE 230
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5000
Practice Address - Country:US
Practice Address - Phone:847-847-5337
Practice Address - Fax:630-834-8091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL019020242OtherLICENSE