| Sleep & Neurology Center Of Southern Illinois, Llc | |
|
2 Good Samaritan Way Suite 400 Mount Vernon IL 62864-2478 | |
| (618) 241-1869 | |
| Not Available |
| Full Name | Sleep & Neurology Center Of Southern Illinois, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2 Good Samaritan Way, Mount Vernon, Illinois |
| Authorized Official Name and Position | John Snodsmith (REGIONAL VP FINANCE, CFO) |
| Authorized Official Contact | 6188991040 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sleep & Neurology Center Of Southern Illinois, Llc 2 Good Samaritan Way Suite 400 Mount Vernon IL 62864-2478 Ph: (618) 241-1869 | Sleep & Neurology Center Of Southern Illinois, Llc 2 Good Samaritan Way Suite 400 Mount Vernon IL 62864-2478 Ph: (618) 241-1869 |
| NPI Number | 1053437038 |
|---|---|
| Provider Enumeration Date | 03/22/2007 |
| Last Update Date | 08/20/2021 |
| Certification Date | 08/20/2021 |
| Medicare PECOS PAC ID | 3779678602 |
|---|---|
| Medicare Enrollment ID | O20160829002710 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053437038 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084S0012X | Psychiatry & Neurology - Sleep Medicine | (* (Not Available)) | Primary |
| Provider Name | Sajjan K Nemani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649220542 PECOS PAC ID: 2668437195 Enrollment ID: I20041124000183 |
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