Healthcare Provider Details

I. General information

NPI: 1447583299
Provider Name (Legal Business Name): STAR DIAGNOSTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2009
Last Update Date: 09/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3845 MCCOY DR STE 101B
AURORA IL
60504-4429
US

IV. Provider business mailing address

3845 MCCOY DR STE 101B
AURORA IL
60504-4429
US

V. Phone/Fax

Practice location:
  • Phone: 630-952-1412
  • Fax: 630-952-1447
Mailing address:
  • Phone: 630-952-1412
  • Fax: 630-952-1447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROSEY CHHIBBER
Title or Position: PRESIDENT
Credential:
Phone: 630-952-1412