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General NPI Number Information
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NPI Number | 1407189731
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Entity Type | Organization
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Legal Business Name | STARRETT MEDICAL ASSOCIATES SC
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Dates
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Enumeration Date | 09/18/2009
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Last Update Date | 09/18/2009
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Provider Practice Location Address
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Address Line | 1300 N HIGHLAND AVE STE. 10
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City | AURORA
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State | IL
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Zip | 60506-1451
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Country | US
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Telephone | 630-892-7629
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Fax | 630-892-7690
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Provider Business Mailing Address
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Address Line | 1300 N HIGHLAND AVE STE. 10
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City | AURORA
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State | IL
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Zip | 60506-1451
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Country | US
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Telephone | 630-892-7629
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Fax | 630-892-7690
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Authorized Official
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Title or Position | MEDICAL SUPERVISOR
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Name | DR. PETER J. STARRETT
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Credential | M.D.
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Telephone | 630-892-7629
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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