Organization
SOUTH CHICAGO SLEEP LAB, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUDEEP BISLA (PRESIDENT)
(312) 955-8084
Entity
Organization
Contact information
Practice address
9011 S COMMERCIAL AVE, SUITE 202, CHICAGO, IL 60617-4304
(773) 375-1845
Mailing address
512 N MCCLURG CT, #3207, CHICAGO, IL 60611-5359
(312) 545-7425
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
1769484
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1636864
BCBS
IL
Enumeration date
11/30/2006
Last updated
02/22/2008
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