Organization
ILLINOIS INSTITUTE OF DENTAL SLEEP MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAILIN SPENCER (DIRECTOR OF MEDICAL BILLING)
(309) 282-8565
Entity
Organization
Contact information
Practice address
11825 STATE ROUTE 40, DUNLAP, IL 61525-8842
(309) 243-9239
Mailing address
11825 STATE ROUTE 40, 100, DUNLAP, IL 61525-8842
(309) 243-8980
(309) 243-8983
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019019599
IL
Other
Enumeration date
11/19/2009
Last updated
04/25/2013
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