MEDICARE: STARLIGHT AUTISM CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1780423038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STARLIGHT AUTISM CENTER

Provider Business Mailing Address
First Line	:	16730 LEE ST
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60467-8709
Country	:	US
Telephone Number	:	708-275-6104
Fax Number	:

Provider Business Practice Location Address
First Line	:	16730 LEE ST
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60467-8709
Country	:	US
Telephone Number	:	708-275-6104
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	NOHA HASAN
Credential	:	BCBA
Telephone Number	:	708-275-6104

Provider Enumeration Date	:	05/24/2024
Last Update Date	:	05/24/2024

Similar Medicare Providers

1326978990 — KARIEMEH KANAN RBT
Practice Location Address:

16730 LEE ST
ORLAND PARK, IL
60467-8709

Practice Phone: 574-344-9073
Practice Fax:

1013763879 — NOHA A HASAN BEHAVIOR ANALYST
Practice Location Address:

16730 LEE ST
ORLAND PARK, IL
60467-8709

Practice Phone: 708-275-6104
Practice Fax:

1881772267 — MRS. BRENDA LEE ESTES CRNA
Practice Location Address:

249 MIDWAY MEDICAL PARK
BRISTON, TN
37620-8709

Practice Phone: 423-968-3033
Practice Fax: 423-968-3789

1538534813 — BRETT LOVE
Practice Location Address:

7518 CRANES CREEK CT
WINTER PARK, FL
32792-8709

Practice Phone: 407-480-1751
Practice Fax:

1790143600 — THOMAS ROWE DENTISTRY PLLC
Practice Location Address:

400 N PARK AVE , #12A
BRECKENRIDGE, CO
80424-8709

Practice Phone: 970-453-4585
Practice Fax:

1922540178 — JEFFERY RUSH
Practice Location Address:

400 N PARK AVE , 10 B
BRECKENRIDGE, CO
80424-8709

Practice Phone: 970-453-5631
Practice Fax:

Directions to “STARLIGHT AUTISM CENTER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.