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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