NPIMap

Organization Active NPI

Goodhealth Home Care, Inc.

  • Home Health Agency
  • Chicago, IL
National Provider Identifier
1013151752
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
GOODHEALTH HOME CARE, INC.
Practice address
9644 S Commercial Ave
Chicago, IL 60617-5021
Phone
(773) 933-6020
Fax
(773) 933-6025
NPI assigned
Apr 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Authorized official

Name
Mrs. Nellie A Smith, RN
Title
Owner
Phone
(773) 933-6020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X IL Primary

Addresses

Primary practice location

9644 S Commercial Ave
Chicago, IL 60617-5021

Mailing address

9644 S Commercial Ave
Chicago, IL 60617-5021
Phone (773) 933-6020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110525000471 IL Part A Provider - Home Health Agency 3678759719 Practice locations: Chicago, IL

Home health agency certification: CCN 148346

Legal name
GOODHEALTH HOME CARE, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 3, 2013
Last certification
Jan 3, 2013
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Aug 1, 2009 in IL
Enrollment address
9644 S Commercial Ave
Chicago, IL 60617

Care Compare: Home health agency

Medicare Care Compare
Listed as
Good Health Home Care, IncCCN 148346
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Jan 3, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

9644 S Commercial Ave
Chicago, IL 60617
Phone (773) 933-6020

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Justina Okoroh Individual 5% Or Greater Direct Ownership Interest Jan 29, 2011
Goodhealth Home Care, Inc. Organization, Chicago, IL General Partnership Interest Jan 29, 2011
Jasper Ofoma Individual 5% Or Greater Direct Ownership Interest Jan 29, 2011
W-2 Managing Employee Jan 29, 2011

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657584000000",
    "number": "1013151752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9644 S COMMERCIAL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606175021",
            "telephone_number": "773-933-6020",
            "fax_number": "773-933-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9644 S COMMERCIAL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606175021",
            "telephone_number": "773-933-6020",
            "fax_number": "773-933-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODHEALTH HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-24",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "NELLIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-933-6020",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.