| Organization Name: | SLEEP & NEUROLOGY CENTER OF SOUTHERN ILLINOIS, LLC |
| NPI Number: | 1053437038 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK CLARK (VICE PRESIDENT) |
| Mailing Address: | #13 Cusumano Professional Plaza Drive Mt. Vernon |
| State: | IL US |
| Postal Code: | 62864 |
| Phone Number: | 6184366203 |
| Fax Number: | |
| NPI Enumeration Date: | 03/22/2007 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084S0012X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Sleep Medicine |
| Taxonomy Definition: | A Psychiatrist or Neurologist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders. |