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Organization

SLEEP CENTER OF CENTRAL ILLINOIS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRIAN J MCDONALD (DIRECTOR)
(309) 663-9999
Entity
Organization

Contact information

Practice address
2204 EASTLAND DR, SUITE 100, BLOOMINGTON, IL 61704-3567
(309) 662-1558
(309) 662-1390
Mailing address
2204 EASTLAND DRIVE, SUITE 100, BLOOMINGTON, IL 61704
(309) 662-1558
(309) 662-1390

Taxonomy

Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5732085
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/29/2006
Last updated
04/20/2012
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