Provider Demographics
NPI:1508449620
Name:STARLING-LEE, EDLENA (NPT)
Entity Type:Individual
Prefix:MRS
First Name:EDLENA
Middle Name:
Last Name:STARLING-LEE
Suffix:
Gender:F
Credentials:NPT
Other - Prefix:MRS
Other - First Name:EDLENA
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:EDLENA LEE
Mailing Address - Street 1:525 E 161ST PL
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-1618
Mailing Address - Country:US
Mailing Address - Phone:708-574-8045
Mailing Address - Fax:
Practice Address - Street 1:525 E 161ST PL
Practice Address - Street 2:
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-1618
Practice Address - Country:US
Practice Address - Phone:708-574-8045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL20-1183Y09246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty