Organization
SHORE LIGHT BEHAVIORAL HEALTH OF ILLINOIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN H VANHOOSER (DIRECTOR OF COMPLIANCE)
(949) 750-2014
Entity
Organization
Contact information
Practice address
6775 PROSPERI DR, TINLEY PARK, IL 60477-4789
(888) 486-6717
Mailing address
2955 E 1ST AVE STE 200, DENVER, CO 80206-5636
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Enumeration date
05/19/2025
Last updated
05/19/2025
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