Organization
NORTH STAR DME &DENTAL LAB INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELITO ADAYA (PRESIDENT)
(224) 628-5685
Entity
Organization
Contact information
Practice address
559 N WOLF RD, WHEELING, IL 60090-3027
(224) 676-1052
(847) 947-2194
Mailing address
559 N WOLF RD, WHEELING, IL 60090-3027
(224) 676-1052
(847) 947-2194
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A-300-0047-0280
DRIVERS LIC.
IL
Enumeration date
06/13/2011
Last updated
06/13/2011
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