SOUTH CHICAGO SLEEP LAB INC. NPI 1912074147

NPI Information

NPI: 1912074147
Provider Name: SOUTH CHICAGO SLEEP LAB, INC.
Classification: Clinic/Center - 261QS1200X
Entity Type: Organization

Specialization: Sleep Disorder Diagnostic

CLIA Number: 14D2249148

Address:
9011 S COMMERCIAL AVE
SUITE 202
CHICAGO, IL
ZIP 60617
Phone: (773) 375-1845
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SOUTH CHICAGO SLEEP LAB, INC. is a sleep disorder diagnostic clinic center in Chicago, IL. SOUTH CHICAGO SLEEP LAB, INC. NPI is 1912074147. The provider is registered as an organization entity type.

The provider's business location address is:

9011 S COMMERCIAL AVE
SUITE 202
CHICAGO, IL
ZIP 60617-304
Phone: (773) 375-1845

The provider's authorized official is Sudeep Bisla .
The authorized official title is President and has the following contact phone number (312) 955-8084.

The CLIA number assigned to this NPI record is 14D2249148 - ancillary test site with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/30/2006 and was last updated on 2/22/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QS1200X	Clinic/Center	Sleep Disorder Diagnostic	1769484	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	214836	MEDICARE PIN	ILLINOIS
2	1636864	OTHER	ILLINOIS	BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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