Provider Demographics
NPI:1073214631
Name:BRIGHTSTAR WI OPERATIONS LLC
Entity Type:Organization
Organization Name:BRIGHTSTAR WI OPERATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PALLASCHKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-856-7663
Mailing Address - Street 1:1125 TRI STATE PKWY STE 700
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-9177
Mailing Address - Country:US
Mailing Address - Phone:847-693-2003
Mailing Address - Fax:
Practice Address - Street 1:3240 UNIVERSITY AVE STE 3A
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3570
Practice Address - Country:US
Practice Address - Phone:608-441-8620
Practice Address - Fax:608-441-8622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health