Provider Demographics
NPI:1952541922
Name:NORTHERN ILLINOIS SLEEP CENTER, S.C
Entity Type:Organization
Organization Name:NORTHERN ILLINOIS SLEEP CENTER, S.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVEK
Authorized Official - Middle Name:
Authorized Official - Last Name:THAPPA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-316-1899
Mailing Address - Street 1:PO BOX 5023
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61125-0023
Mailing Address - Country:US
Mailing Address - Phone:815-316-1899
Mailing Address - Fax:815-316-1897
Practice Address - Street 1:1958 ABERDEEN CT
Practice Address - Street 2:SUITE 2
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-3175
Practice Address - Country:US
Practice Address - Phone:815-787-7997
Practice Address - Fax:815-316-7897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036081657261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic