Provider Demographics
NPI:1841249646
Name:CHICAGO SLEEP DISORDERS CENTER
Entity type:Organization
Organization Name:CHICAGO SLEEP DISORDERS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ANSFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-774-7300
Mailing Address - Street 1:3401 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-4426
Mailing Address - Country:US
Mailing Address - Phone:773-725-7000
Mailing Address - Fax:773-725-7002
Practice Address - Street 1:3401 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-4426
Practice Address - Country:US
Practice Address - Phone:773-725-7000
Practice Address - Fax:773-725-7002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory