Provider Demographics
NPI:1699043349
Name:STAR LIGHTS HOME HEALTH CARE CORP.
Entity Type:Organization
Organization Name:STAR LIGHTS HOME HEALTH CARE CORP.
Other - Org Name:STAR LIGHTS HOME HEALTH CARE CORP.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DON
Authorized Official - Prefix:MS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:NKECHI
Authorized Official - Last Name:OLUMBA
Authorized Official - Suffix:I
Authorized Official - Credentials:RN
Authorized Official - Phone:773-506-7110
Mailing Address - Street 1:5765 N LINCOLN AVE
Mailing Address - Street 2:SUITE 14
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-4720
Mailing Address - Country:US
Mailing Address - Phone:773-506-7110
Mailing Address - Fax:773-506-4088
Practice Address - Street 1:5765 N LINCOLN AVE
Practice Address - Street 2:SUITE 14
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-4720
Practice Address - Country:US
Practice Address - Phone:773-506-7110
Practice Address - Fax:773-506-4088
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STAR LIGHTS HOME HEALTH CARE CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041268143251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care