Provider Demographics
NPI:1548485550
Name:STAR FOUNDATION
Entity type:Organization
Organization Name:STAR FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BEATTA
Authorized Official - Middle Name:
Authorized Official - Last Name:KABBANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-729-7063
Mailing Address - Street 1:3633 W LAKE AVE STE LL2
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-5812
Mailing Address - Country:US
Mailing Address - Phone:847-729-7063
Mailing Address - Fax:
Practice Address - Street 1:3633 W LAKE AVE STE LL2
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-5812
Practice Address - Country:US
Practice Address - Phone:847-729-7063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Not Answered251V00000XAgenciesVoluntary or Charitable