Healthcare Provider Details

I. General information

NPI: 1528812948
Provider Name (Legal Business Name): GOLDEN STAR HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2024
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4017 OLD GRAND AVE
GURNEE IL
60031-2848
US

IV. Provider business mailing address

4017 OLD GRAND AVE
GURNEE IL
60031-2848
US

V. Phone/Fax

Practice location:
  • Phone: 224-946-6859
  • Fax:
Mailing address:
  • Phone: 224-946-6859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. MARINA AURELIO ESTRELLA
Title or Position: OWNER
Credential: FNP
Phone: 224-946-6859