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Organization
INTEGRATED PROFESSIONAL SERV LLC
Active
Organization
INTEGRATED PROFESSIONAL SERV LLC
Active
Other names
Utah Sleep Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IKHTIARUN NABI (MANAGER)
(801) 747-0921
Entity
Organization
Contact information
Practice address
515 E 4500 S, SUITE G-220, SALT LAKE CITY, UT 84107-4500
(801) 747-0921
(801) 747-0986
Mailing address
PO BOX 651004, SALT LAKE CITY, UT 84165-1004
(801) 747-0921
(801) 747-0986
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
44633
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
470001928
RR MEDICARE
UT
01
—
51803040100001
BLUE CROSS BLUE SHIELD
UT
01
—
606218700
ACS US DEPT. OF LABOR
UT
01
—
72595
PEHP
UT
01
—
QM0000061972
ALTIUS HEALTH PLANS
UT
Enumeration date
11/22/2006
Last updated
01/26/2012
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