Provider Demographics
NPI:1487692893
Name:MIDWEST SLEEP LAB INC
Entity type:Organization
Organization Name:MIDWEST SLEEP LAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SULTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-423-9982
Mailing Address - Street 1:5702 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2345
Mailing Address - Country:US
Mailing Address - Phone:708-423-9982
Mailing Address - Fax:708-423-9984
Practice Address - Street 1:5702 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2345
Practice Address - Country:US
Practice Address - Phone:708-423-9982
Practice Address - Fax:708-423-9984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL208286Medicare ID - Type Unspecified