Organization Active NPI

Star Medcare Group LLC

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1548094360
Registry record updated Jan 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
STAR MEDCARE GROUP LLC
Practice address
11101 S State St
Chicago, IL 60628-4206
Phone
(630) 730-2159
NPI assigned
Aug 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Noman Khokher
Title
Adminstrator
Phone
(773) 672-3376

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X

Addresses

Primary practice location

11101 S State St
Chicago, IL 60628-4206

Mailing address

7933 Oakview LN
Woodridge, IL 60517-3742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250317001126 IL Part B Supplier - Clinic/Group Practice 8527580836 Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737763200000",
    "number": "1548094360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7933 OAKVIEW LN",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605173742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11101 S STATE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284206",
            "telephone_number": "630-730-2159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR MEDCARE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-26",
        "last_updated": "2025-01-25",
        "certification_date": "2025-01-25",
        "status": "A",
        "authorized_official_last_name": "KHOKHER",
        "authorized_official_first_name": "NOMAN",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "773-672-3376"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.