North Star Medical Supply, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

NORTH STAR MEDICAL SUPPLY, INC.

Practice address

143 Shadowbend Dr
Wheeling, IL 60090-3151

Phone

(224) 628-5685

NPI assigned

Dec 21, 2011

Last updated

Dec 21, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angelito Adaya

Title

President

Phone

(224) 628-5685

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1324425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324425600000",
    "number": "1568731479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 SHADOWBEND DR",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600903151",
            "telephone_number": "224-628-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 SHADOWBEND DR",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600903151",
            "telephone_number": "224-628-5685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH STAR MEDICAL SUPPLY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-21",
        "last_updated": "2011-12-21",
        "status": "A",
        "authorized_official_last_name": "ADAYA",
        "authorized_official_first_name": "ANGELITO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "224-628-5685"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.