Organization Active NPI

All Star Pediatrics, P.C.

  • Pediatrics Physician
  • Countryside, IL
National Provider Identifier
1962419937
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
ALL STAR PEDIATRICS, P.C.
Practice address
6410 Joliet Rd
Countryside, IL 60525-4642
Phone
(708) 352-4448
Fax
(708) 352-1052
NPI assigned
Aug 2, 2006
Last updated
Mar 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Authorized official

Name
Mrs. Donna Ruge
Title
Office Manager
Phone
(708) 352-4448

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

6410 Joliet Rd
Countryside, IL 60525-4642

Mailing address

6410 Joliet Rd
Countryside, IL 60525-4642
Phone (708) 352-4448

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0421526All Star Pediatrics PC6410 Joliet Rd, Ste 3, Countryside, IL 60525Certificate of waiverDec 6, 2026

National Provider Directory

National Provider Directory

Locations

6410 Joliet Rd
Countryside, IL 60525
Phone (708) 352-4448

6410 Joliet Rd
Ste 3
Countryside, IL 60525

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710892800000",
    "number": "1962419937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 JOLIET RD",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "605254642",
            "telephone_number": "708-352-4448",
            "fax_number": "708-352-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 JOLIET RD",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "605254642",
            "telephone_number": "708-352-4448",
            "fax_number": "708-352-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALL STAR PEDIATRICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "RUGE",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "708-352-4448",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Countryside, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.