Home Health Agency Illinois, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1010196 Issued in IL

Legal business name

HOME HEALTH AGENCY ILLINOIS, LLC

Doing business as

Omni Home Care

Practice address

19146 88TH Ave
Mokena, IL 60448-8135

Phone

(708) 532-4466

Fax

(708) 532-4477

NPI assigned

Sep 15, 2005

Last updated

Jul 10, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jorge Rico

Title

Manager

Phone

(305) 476-5160

Specialties & licenses 1

Addresses

Other names 1

• Omni Home Care Doing business as

Locations

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341878400000",
    "number": "1033104039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 HOSPITAL DR",
            "address_2": "SUITE 100",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371155033",
            "telephone_number": "615-712-2250",
            "fax_number": "615-577-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19146 88TH AVE",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488135",
            "telephone_number": "708-532-4466",
            "fax_number": "708-532-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME HEALTH AGENCY ILLINOIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-15",
        "last_updated": "2012-07-10",
        "status": "A",
        "authorized_official_last_name": "RICO",
        "authorized_official_first_name": "JORGE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "305-476-5160"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1010196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omni Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Mokena, IL
• Providers in Mokena, IL by specialty
• Home Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; 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.