Provider Demographics
NPI:1770884819
Name:ASTER HOME HEALTH SERVICE, LLC
Entity type:Organization
Organization Name:ASTER HOME HEALTH SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:
Authorized Official - Last Name:OWEIMRIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:773-267-5500
Mailing Address - Street 1:3101 N CALIFORNIA AVE
Mailing Address - Street 2:SUITE 1S
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-7007
Mailing Address - Country:US
Mailing Address - Phone:773-267-5500
Mailing Address - Fax:773-267-5501
Practice Address - Street 1:3101 N CALIFORNIA AVE
Practice Address - Street 2:SUITE 1S
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-7007
Practice Address - Country:US
Practice Address - Phone:773-267-5500
Practice Address - Fax:773-267-5501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILPENDINGOtherPENDING