Healthcare Provider Details

I. General information

NPI: 1306674536
Provider Name (Legal Business Name): STELLAR ANESTHESIA SPECIALISTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 N ASHLAND AVE STE 1N
CHICAGO IL
60622
US

IV. Provider business mailing address

830 N ASHLAND AVE STE 1N
CHICAGO IL
60622
US

V. Phone/Fax

Practice location:
  • Phone: 773-280-7001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: SAMEER SHAH
Title or Position: PARTNER
Credential: MD
Phone: 773-280-7001