Organization
DIGITRACE CARE SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL R. IBERGER (EVP-CFO)
(978) 536-7400
Entity
Organization
Contact information
Practice address
2623 N CLARK ST, CHICAGO, IL 60614-1524
(847) 966-7366
(847) 966-7316
Mailing address
200 CORPORATE PL, SUITE 5B, PEABODY, MA 01960-3840
(978) 536-7400
(978) 535-9757
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01619296
FEDERAL BCIL
IL
01
—
8011510
CIGNA
IL
Enumeration date
08/12/2006
Last updated
10/15/2009
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