| Organization Name: | SUBURBAN DENTAL SLEEP MEDICINE |
| NPI Number: | 1386016731 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RUBINA NGUYEN (OWNER) |
| Mailing Address: | 2110 W Algonquin Rd Lake In The Hills |
| State: | IL US |
| Postal Code: | 601561370 |
| Phone Number: | 8478540525 |
| Fax Number: | 8478540451 |
| NPI Enumeration Date: | 10/26/2015 |
| NPI Last Update Date: | 02/17/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |