| S I Neurology & Sleep Medicine Llc | |
|
2731 West Main Street Suite A Carbondale IL 62901 | |
| (618) 549-6378 | |
| (618) 529-2347 |
| Full Name | S I Neurology & Sleep Medicine Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2731 West Main Street, Carbondale, Illinois |
| Authorized Official Name and Position | Fakhre Alam (MD) |
| Authorized Official Contact | 6185496378 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| S I Neurology & Sleep Medicine Llc Po Box 489 Carbondale IL 62903-0489 Ph: (618) 549-6378 | S I Neurology & Sleep Medicine Llc 2731 West Main Street Suite A Carbondale IL 62901 Ph: (618) 549-6378 |
| NPI Number | 1790875987 |
|---|---|
| Provider Enumeration Date | 10/16/2006 |
| Last Update Date | 01/31/2024 |
| Certification Date | 01/31/2024 |
| Medicare PECOS PAC ID | 9335105600 |
|---|---|
| Medicare Enrollment ID | O20041208000526 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790875987 | NPI | - | NPPES |
| 036101704 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 036101704 (Illinois) | Primary |
| Provider Name | Fakhre Alam |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427033828 PECOS PAC ID: 0345236212 Enrollment ID: I20040424000246 |
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