| Prairie Sleep Center LLC | |
|
2900 Greenbriar Dr Springfield IL 62704-6418 | |
| (217) 546-0412 | |
| (217) 546-0919 |
| Full Name | Prairie Sleep Center LLC |
|---|---|
| Speciality | Durable Medical Equipment & Medical Supplies - Customized Equipment |
| Location | 2900 Greenbriar Dr, Springfield, Illinois |
| Authorized Official Name and Position | Tanya L Desanto (DENTIST/OWNER) |
| Authorized Official Contact | 2175460412 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Sleep Center LLC 2900 Greenbriar Dr Springfield IL 62704-6418 Ph: (217) 546-0412 | Prairie Sleep Center LLC 2900 Greenbriar Dr Springfield IL 62704-6418 Ph: (217) 546-0412 |
| NPI Number | 1316598311 |
|---|---|
| Provider Enumeration Date | 09/23/2019 |
| Last Update Date | 10/16/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316598311 | NPI | - | NPPES |
| 1285778522 | Other | IL | DR. TANYA L. DESANTO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (NU) | Secondary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (NU) | Primary |
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