| Illinois Institute Of Dental Sleep Medicine Inc | |
|
11825 State Route 40 Dunlap IL 61525-8842 | |
| (309) 243-9239 | |
| Not Available |
| Full Name | Illinois Institute Of Dental Sleep Medicine Inc |
|---|---|
| Speciality | Dentist |
| Location | 11825 State Route 40, Dunlap, Illinois |
| Authorized Official Name and Position | Cailin Spencer (DIRECTOR OF MEDICAL BILLING) |
| Authorized Official Contact | 3092828565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Illinois Institute Of Dental Sleep Medicine Inc 11825 State Route 40 100 Dunlap IL 61525-8842 Ph: (309) 243-8980 | Illinois Institute Of Dental Sleep Medicine Inc 11825 State Route 40 Dunlap IL 61525-8842 Ph: (309) 243-9239 |
| NPI Number | 1740518380 |
|---|---|
| Provider Enumeration Date | 11/19/2009 |
| Last Update Date | 04/25/2013 |
| Medicare PECOS PAC ID | 9032242078 |
|---|---|
| Medicare Enrollment ID | O20100728000545 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740518380 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019019599 (Illinois) | Primary |
| Provider Name | Rodney Earl Willey |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1144409806 PECOS PAC ID: 4688746159 Enrollment ID: I20080630000074 |
| Provider Name | Brockton R Willey |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1598141087 PECOS PAC ID: 2062729643 Enrollment ID: I20150915000380 |
| Provider Name | Hollie Nicole Hangartner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669015566 PECOS PAC ID: 2961835483 Enrollment ID: I20191213000825 |
Maple Shade Dental (dunlap) Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11825 State Route 40, Suite 200, Dunlap, IL 61525 Phone: 309-243-7702 Fax: 309-243-9061 | |
Koala Center For Sleep & Tmj Disorders Mi-1 Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11825 State Route 40, Suite 100, Dunlap, IL 61525 Phone: 309-839-9971 Fax: 309-807-3365 | |
Maple Shade Dental Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11825 N Knoxville Ave, Dunlap, IL 61525 Phone: 309-243-7702 Fax: 309-243-9559 | |
Illinois Institute Of Dental Sleep Medicine Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11825 State Route 40 Ste 100, Dunlap, IL 61525 Phone: 309-243-8980 |