MEDICARE: SUBURBAN SENIORS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1215983523
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUBURBAN SENIORS, INC.

Provider Business Mailing Address
First Line	:	309 E RAND RD
Second Line	:	#334
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-3103
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	309 E RAND RD
Second Line	:	#334
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-3103
Country	:	US
Telephone Number	:	800-836-2904
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LINDA STARR
Credential	:
Telephone Number	:	800-836-2904

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	08/22/2020

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