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NPI Code Detail

MEDICARE: STAR HEALTH SC

MEDICARE: STAR HEALTH SC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1548832637
Entity Type Code : Organization
Provider Name (Legal Business Name) : STAR HEALTH SC
Provider Business Mailing Address
First Line : 1S072 LUTHER AVE
Second Line :
City : LOMBARD
State : IL
Zip : 60148-4164
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1S072 LUTHER AVE
Second Line :
City : LOMBARD
State : IL
Zip : 60148-4164
Country : US
Telephone Number : 872-888-2444
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : SHAHAAB UDDIN
Credential :
Telephone Number : 872-888-2444
Provider Enumeration Date : 07/16/2021
Last Update Date : 02/08/2023

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Directions to “STAR HEALTH SC ” Practice Location

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