Provider Demographics
NPI:1861532608
Name:SLEEP MEDICINE ASSOCIATES, LLC.
Entity type:Organization
Organization Name:SLEEP MEDICINE ASSOCIATES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:618-993-0086
Mailing Address - Street 1:PO BOX 1433
Mailing Address - Street 2:
Mailing Address - City:MURPHYSBORO
Mailing Address - State:IL
Mailing Address - Zip Code:62966
Mailing Address - Country:US
Mailing Address - Phone:618-993-0086
Mailing Address - Fax:608-993-0088
Practice Address - Street 1:8305 EXPRESS DRIVE, SUITE C
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959
Practice Address - Country:US
Practice Address - Phone:618-993-0086
Practice Address - Fax:618-993-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL660328OtherHEALTHLINK
IL036109663Medicaid
KY0723320Medicaid
IL3932015OtherBLUECROSS BLUESHIELD OF ILLINOIS
ILDF5180OtherRAILROAD MEDICARE- GROUP
IL088817OtherHEALTH ALLIANCE
ILP00118900OtherRAILROAD MEDICARE- PIN
IL208084OtherMEDICARE- GROUP NUMBER
ILDF5180OtherRAILROAD MEDICARE- GROUP
IL208084OtherMEDICARE- GROUP NUMBER