Active NPI
Collaborative Home Health Care
- Home Health Agency
- Evanston, IL
National Provider Identifier
1003111550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryNPI 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.