1568464170 NPI number — SLEEP DISORDERS INSTITUTE MIDWEST LLC

Table of content: MRS. ELIZABETH ANN SUNQUIST ATC (NPI 1992922199)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568464170 NPI number — SLEEP DISORDERS INSTITUTE MIDWEST LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SLEEP DISORDERS INSTITUTE MIDWEST LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SLEEP DISORDERS INSTITUTE MIDWEST
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568464170
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/24/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11881 W 112TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OVERLAND PARK
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66210-2717
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-754-3275
Provider Business Mailing Address Fax Number:
913-754-3276

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11881 W 112TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OVERLAND PARK
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-754-3275
Provider Business Practice Location Address Fax Number:
913-754-3276
Provider Enumeration Date:
08/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
DANG
Authorized Official First Name:
RAJIV
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING DIRECTOR
Authorized Official Telephone Number:
913-754-3275

Provider Taxonomy Codes

  • Taxonomy code: 261QS1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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