Healthcare Provider Details

I. General information

NPI: 1780588053
Provider Name (Legal Business Name): NORTHSTAR COMPANION CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 S WASHINGTON ST
NAPERVILLE IL
60540-6603
US

IV. Provider business mailing address

640 S WASHINGTON ST
NAPERVILLE IL
60540-6603
US

V. Phone/Fax

Practice location:
  • Phone: 773-449-1695
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHAGUFTA AHMED
Title or Position: AGENT
Credential:
Phone: 773-449-1695