Provider Demographics
NPI:1871081331
Name:NORTH STAR MCD, LLC
Entity type:Organization
Organization Name:NORTH STAR MCD, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SASKIW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-649-6460
Mailing Address - Street 1:7600 WINDROSE AVE STE G325
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-0167
Mailing Address - Country:US
Mailing Address - Phone:972-649-6460
Mailing Address - Fax:
Practice Address - Street 1:11970 N CENTRAL EXPY STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3772
Practice Address - Country:US
Practice Address - Phone:214-613-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-30
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology