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General NPI Number Information
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NPI Number | 1881063147
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Entity Type | Organization
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Legal Business Name | STELLAR HOME PHYSICIANS INC
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Dates
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Enumeration Date | 09/16/2015
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Last Update Date | 12/29/2017
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Provider Practice Location Address
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Address Line | 3530 W PETERSON AVE SUITE 109
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City | CHICAGO
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State | IL
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Zip | 60659-3293
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Country | US
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Telephone | 847-436-8081
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Fax |
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Provider Business Mailing Address
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Address Line | 3530 W PETERSON AVE SUITE 109
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City | CHICAGO
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State | IL
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Zip | 60659-3293
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Country | US
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Telephone | 773-859-5415
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Fax | 773-831-1706
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | RAMA SEEDOO
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Credential |
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Telephone | 773-583-0921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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