Healthcare Provider Details

I. General information

NPI: 1588293633
Provider Name (Legal Business Name): STELLAR HOME NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 W PETERSON AVE STE 101
CHICAGO IL
60659-3294
US

IV. Provider business mailing address

3530 W PETERSON AVE STE 101
CHICAGO IL
60659-3294
US

V. Phone/Fax

Practice location:
  • Phone: 312-857-6894
  • Fax: 773-442-0978
Mailing address:
  • Phone: 800-766-0666
  • Fax: 800-297-0666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: RAMA SEEDOO
Title or Position: VP
Credential:
Phone: 773-583-0921