SERTOMA STAR SERVICES INC. NPI 1053503094

NPI Information

  • NPI: 1053503094
  • Provider Name: SERTOMA STAR SERVICES, INC.
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Doing Business As: SOUTHSTAR SERVICES
  • Address: 1005 W END AVE
    CHICAGO HEIGHTS, IL
    ZIP 60411
  • Phone: (708) 755-8030

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NPI Details

SERTOMA STAR SERVICES, INC. is a mental health (including community mental health center) clinic center in Chicago Heights, IL. SERTOMA STAR SERVICES, INC. NPI is 1053503094. The provider is registered as an organization entity type.
The provider Is Doing Business As Southstar Services.

The provider's business location address is:

1005 W END AVE
CHICAGO HEIGHTS, IL
ZIP 60411-742
Phone: (708) 755-8030
Fax: (708) 755-8047

The provider's authorized official is Gus Van Den Brink .
The authorized official title is President/ceo and has the following contact phone number (708) 730-6216.

The enumeration date for this NPI number is 8/14/2007 and was last updated on 2/12/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251C00000XDay Training, Developmentally Disabled Services946232ILLINOISNo
2251S00000XCommunity/Behavioral HealthNo
3320600000XResidential Treatment Facility, Intellectual and/or Developmental Disabilities946232ILLINOISNo
4320800000XCommunity Based Residential Treatment Facility, Mental IllnessNo
5261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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