Organization
SAJJAN K NEMANI MD SC
Active
Other names
Advance Sleep & Neurodiagnostic Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA RENE MINOR (OFFICE MANAGER)
(618) 533-8700
Entity
Organization
Contact information
Practice address
1054 M L KING DR STE 124, CENTRALIA, IL 62801-3065
(618) 533-8700
(618) 533-8701
Mailing address
1054 M L KING DR STE 124, CENTRALIA, IL 62801-3065
(618) 533-8700
(618) 533-8701
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036078556
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036078556
—
IL
01
—
051812
HEALTH ALLIANCE
IL
01
—
06123524
BLUE CROSS
IL
01
—
111163
HEALTHLINK
IL
Enumeration date
05/10/2007
Last updated
07/19/2021
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