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General NPI Number Information
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NPI Number | 1669846085
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Entity Type | Organization
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Legal Business Name | STARLIGHT THERAPY SERVICES LIMITED
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Dates
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Enumeration Date | 11/23/2015
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Last Update Date | 11/23/2015
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Provider Practice Location Address
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Address Line | 4 FAIRFAX CT
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City | BOLINGBROOK
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State | IL
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Zip | 60490-5039
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Country | US
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Telephone | 630-870-0631
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Fax |
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Provider Business Mailing Address
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Address Line | 4 FAIRFAX CT
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City | BOLINGBROOK
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State | IL
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Zip | 60490-5039
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Country | US
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Telephone | 630-870-0631
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NARGESS SYED
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Credential |
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Telephone | 630-947-4479
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | D68667232
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License Number State | IL
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