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Organization

ENT & SLEEP MEDICINE ASSOCIATES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KELLI BLAGG (BUSINESS MANAGER)
(618) 628-0715
Entity
Organization

Contact information

Practice address
1000 ELEVEN S STE 4F, COLUMBIA, IL 62236-1080
(618) 628-0715
(888) 371-4468
Mailing address
1000 ELEVEN S STE 4F, COLUMBIA, IL 62236-1080
(618) 628-0715
(888) 371-4468

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036101869
IL
207YS0012X
Sleep Medicine (Otolaryngology) Physician
036101869
IL

Other

Enumeration date
10/16/2010
Last updated
11/03/2020
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