Healthcare Provider Details
I. General information
NPI: 1982527347
Provider Name (Legal Business Name): STARLIGHT ABA IL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
920 S SPRING ST
SPRINGFIELD IL
62704-2725
US
IV. Provider business mailing address
920 S SPRING ST
SPRINGFIELD IL
62704-2725
US
V. Phone/Fax
- Phone: 347-454-6140
- Fax:
- Phone: 347-454-6140
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RAIZEL
LEBOVITS
Title or Position: DIRECTOR
Credential:
Phone: 347-454-6140