| Brander Sleep Wellness Ltd. | |
|
5668 E State St Suite 1100 Rockford IL 61108-2490 | |
| (815) 977-5281 | |
| (815) 977-5361 |
| Full Name | Brander Sleep Wellness Ltd. |
|---|---|
| Speciality | Dentist |
| Location | 5668 E State St, Rockford, Illinois |
| Authorized Official Name and Position | Lonn Edward Brander (OWNER) |
| Authorized Official Contact | 8157562295 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brander Sleep Wellness Ltd. 5668 E State St Suite 1100 Rockford IL 61108-2490 Ph: (815) 977-5281 | Brander Sleep Wellness Ltd. 5668 E State St Suite 1100 Rockford IL 61108-2490 Ph: (815) 977-5281 |
| NPI Number | 1477975175 |
|---|---|
| Provider Enumeration Date | 01/15/2014 |
| Last Update Date | 09/08/2014 |
| Medicare PECOS PAC ID | 9032340773 |
|---|---|
| Medicare Enrollment ID | O20140324000858 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477975175 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019-022322 (Illinois) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
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