Sleep Solutions of Central Illinois LLC

Primary specialty

DentistTaxonomy code 122300000X

License

019021753 Issued in IL

Legal business name

SLEEP SOLUTIONS OF CENTRAL ILLINOIS LLC

Doing business as

Koala Center for Sleep Disorders

Practice address

2309 E Empire St
Ste. 500
Bloomington, IL 61704-8636

Phone

(309) 319-6568

Fax

(309) 664-0352

NPI assigned

Feb 15, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. James Todd Gray, DDSNPI 1164659918

Title

Owner/Dentist

Phone

(309) 319-6568

Specialties & licenses 1

Addresses

Other names 1

• Koala Center for Sleep Disorders Doing business as

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

Tax ID family

Koala Center for Sleep Disorders2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sleep Solutions of Central Illinois

  • Dentist
  • Bloomington, IL
  • NPI 1194181560
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James T Gray, DDS

  • General Practice Dentistry
  • East Peoria, IL
  • NPI 1164659918
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461715200000",
    "number": "1013280445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 E EMPIRE ST",
            "address_2": "STE. 500",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617048636",
            "telephone_number": "309-319-6568",
            "fax_number": "309-664-0352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 E EMPIRE ST",
            "address_2": "STE. 500",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617048636",
            "telephone_number": "309-319-6568",
            "fax_number": "309-664-0352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLEEP SOLUTIONS OF CENTRAL ILLINOIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-15",
        "last_updated": "2016-04-27",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "309-319-6568",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019021753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Koala Center for Sleep Disorders",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashish Singal, MD/PHD,MS,MBA,NREMT
• Alyssa Ann Skelton
• Thomas Lloyd Slattery, PSY.D.
• Sleep Center of Central Illinois LLC
• Sleep Solutions of Central Illinois
• Sarah Sleeter, MS, CCC-SLP
• Barry Slotky, MD
• Grace Mragret Slowikowski
• Smalltown Dental Bloomington on Maloney
• Smart Health & Wellness Center, LLC

• Dentist in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.