Awesome Star Enterprise Inc

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

AWESOME STAR ENTERPRISE INC

Practice address

15525 S Park Ave
Suite 100
South Holland, IL 60473-1308

Phone

(708) 357-1052

Fax

(888) 510-2447

NPI assigned

Oct 7, 2015

Organization subpart

No

Name

Kewana Reese

Title

Owner

Phone

(773) 531-9787

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 7, 2015.

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1861863532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15525 S PARK AVE",
            "address_2": "SUITE 100",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731308",
            "telephone_number": "708-357-1052",
            "fax_number": "888-510-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15525 S PARK AVE",
            "address_2": "SUITE 100",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731308",
            "telephone_number": "708-357-1052",
            "fax_number": "888-510-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AWESOME STAR ENTERPRISE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "REESE",
        "authorized_official_first_name": "KEWANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-531-9787"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "ZZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Medical Supply LLC
• Janiese Myesha Asque
• Girma Balcha Assefa, M.D.
• Aunt Martha'S Health and Wellness, Inc.
• Aunt Martha'S Youth Service Center Inc
• B.O.O.C. Inc.
• Ellamonique Baccus
• Sameera Baig, MD
• Candyce Banks, OTR
• Susan Barclay, MD

• All providers in South Holland, IL
• Non-emergency Medical Transport (VAN) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; 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.