Organization Active NPI

Collaborative Home Health Care

  • Home Health Agency
  • Evanston, IL
National Provider Identifier
1003111550
Registry record updated Jan 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
COLLABORATIVE HOME HEALTH CARE
Practice address
1810 Lake St
Second Floor
Evanston, IL 60201-4068
Phone
(224) 420-2766
NPI assigned
Jan 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Olubukola (Buki) Fabusiwa, PHARMD
Title
Administrator
Phone
(847) 873-9122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1810 Lake St
Second Floor
Evanston, IL 60201-4068

Mailing address

1810 Lake St
Second Floor
Evanston, IL 60201-4068
Phone (224) 420-2766

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294876800000",
    "number": "1003111550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 LAKE ST",
            "address_2": "SECOND FLOOR",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014068",
            "telephone_number": "224-420-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 LAKE ST",
            "address_2": "SECOND FLOOR",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014068",
            "telephone_number": "224-420-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE HOME HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-13",
        "last_updated": "2011-01-13",
        "status": "A",
        "authorized_official_last_name": "FABUSIWA",
        "authorized_official_first_name": "OLUBUKOLA (BUKI)",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "847-873-9122",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.