Organization
SOUTHERN ILLINOIS SLEEP INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANITA G. HOPKIN R.PSG.T. (BILLING MANAGER)
(314) 645-5855
Entity
Organization
Contact information
Practice address
105 AIRWAY DR, MARION, IL 62959-5872
(618) 997-5500
(618) 997-5501
Mailing address
PO BOX 797090, SAINT LOUIS, MO 63179-7000
(314) 645-5855
(314) 645-6446
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010032043
BLUE CROSS PROVIDER #
IL
Enumeration date
05/01/2006
Last updated
01/18/2008
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