# MIDWEST CENTER FOR SLEEP MEDICINE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730128315
- **Authorized official:** DR. LESLIE E MATHERS III M.D. (PRESIDENT BOARD OF DIRECTORS)
- **Authorized official phone:** (309) 664-3061

## Contact information

- **Practice address:** 1709 JUMER DR, BLOOMINGTON, IL 61704
- **Practice address phone:** (309) 662-9997
- **Practice address fax:** (309) 663-9917
- **Mailing address:** 1709 JUMER DR, BLOOMINGTON, IL 61704-0914
- **Mailing address phone:** (309) 662-9997
- **Mailing address fax:** (309) 663-9917

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | NA | IL | Yes |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 06/06/2006
- **Last updated:** 08/22/2020