Provider Demographics
NPI:1881920593
Name:JOLIET SLEEP CENTER INC
Entity type:Organization
Organization Name:JOLIET SLEEP CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PADMAJA
Authorized Official - Middle Name:
Authorized Official - Last Name:NANNAPANENI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-887-1262
Mailing Address - Street 1:1603 WOODLAND LN
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60490-3274
Mailing Address - Country:US
Mailing Address - Phone:630-887-1262
Mailing Address - Fax:
Practice Address - Street 1:2000 GLENWOOD AVE
Practice Address - Street 2:109
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-5676
Practice Address - Country:US
Practice Address - Phone:815-729-0111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty