Organization
HOME SLEEP DIAGNOSTICS
Active
Other names
Sleep Diagnostic Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AHUVA ELANA SHABAT (PRESIDENT)
(773) 262-4110
Entity
Organization
Contact information
Practice address
2522 W PETERSON AVE, CHICAGO, IL 60659-4109
(773) 262-4110
(773) 784-0701
Mailing address
2522 W PETERSON AVE, CHICAGO, IL 60659-4109
(773) 262-4110
(773) 784-0701
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001620869
BCBS PROVIDER #
IL
Enumeration date
08/16/2006
Last updated
08/28/2007
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