Provider Demographics
NPI:1801831623
Name:SUBURBAN SENIORS INC
Entity Type:Organization
Organization Name:SUBURBAN SENIORS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:H
Authorized Official - Last Name:STARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-836-2904
Mailing Address - Street 1:6300 KINGERY HWY
Mailing Address - Street 2:#359
Mailing Address - City:WILLOW BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-2248
Mailing Address - Country:US
Mailing Address - Phone:630-261-0680
Mailing Address - Fax:
Practice Address - Street 1:1S224 SUMMIT AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3983
Practice Address - Country:US
Practice Address - Phone:630-261-0680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209964Medicare ID - Type Unspecified