Organization Active NPI

Suburban Dental Sleep Medicine LLC

  • Customized Equipment (DME)
  • Elgin, IL
National Provider Identifier
1386016731
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
SUBURBAN DENTAL SLEEP MEDICINE LLC
Practice address
500 N McLean Blvd Ste 102
Elgin, IL 60123-3275
Phone
(847) 854-3031
Fax
(224) 227-6906
NPI assigned
Oct 26, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Rubina NguyenNPI 1457792640
Title
Owner
Phone
(847) 854-0525

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019.025559 IL
Customized Equipment (DME) 332BC3200X Primary

Addresses

Primary practice location

500 N McLean Blvd Ste 102
Elgin, IL 60123-3275

Mailing address

500 N McLean Blvd Ste 102
Elgin, IL 60123-3275
Phone (847) 854-3031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160205001857 IL DME Supplier - Oral Surgery - Dentist 5294039558 Practice locations: Elgin, IL

National Provider Directory

National Provider Directory

Locations

500 N McLean Blvd
Ste 102
Elgin, IL 60123
Phone (847) 854-3031

500 N McLean Blvd
#102
Elgin, IL 60123

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1386016731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N MCLEAN BLVD STE 102",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601233275",
            "telephone_number": "847-854-3031",
            "fax_number": "224-227-6906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N MCLEAN BLVD STE 102",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601233275",
            "telephone_number": "847-854-3031",
            "fax_number": "224-227-6906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN DENTAL SLEEP MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "RUBINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-854-0525"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.025559",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.