Organization Active NPI

FJ Home Health Care Inc

  • Home Health Agency
  • Oak Lawn, IL
National Provider Identifier
1053445320
Registry record updated Feb 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
FJ HOME HEALTH CARE INC
Practice address
4507 W 95TH St
Oak Lawn, IL 60453-2621
Phone
(708) 581-3500
Fax
(708) 581-3505
NPI assigned
Mar 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2017

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

Authorized official

Name
Sara Tariq
Title
Administrator
Phone
(708) 581-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

4507 W 95TH St
Oak Lawn, IL 60453-2621

Mailing address

4507 W 95TH St
Oak Lawn, IL 60453-2621
Phone (708) 581-3500

Other identifiers 1

IdentifierTypeStateIssuer
50270OtherILBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100203000507 IL Part A Provider - Home Health Agency 8224948872 Practice locations: Evergreen Park, IL

Home health agency certification: CCN 147737

Legal name
FJ HOME HEALTH CARE INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 4, 2003
Last certification
Dec 15, 2011
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
May 31, 2002 in IL
Enrollment address
3847 W 95TH St
Evergreen Park, IL 60805-2020

Care Compare: Home health agency

Medicare Care Compare
Listed as
F J Home Health Care IncCCN 147737
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Apr 4, 2003
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

16650 Harlem Ave
Ste 3
Tinley Park, IL 60477

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
Kamran Anis Individual W-2 Managing EmployeeAdministrator Dec 15, 2009 100%
Mubashir Ali Khan Individual 5% Or Greater Direct Ownership InterestPresident May 31, 2002 100%
Corporate OfficerPresident May 31, 2002 100%
Corporate DirectorPresident May 31, 2002 100%
W-2 Managing EmployeePresident May 31, 2002 100%
Operational/Managerial ControlPresident May 31, 2002 100%
Sara Tariq Individual W-2 Managing EmployeeAdministrator Nov 1, 2016

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485993600000",
    "number": "1053445320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4507 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532621",
            "telephone_number": "708-581-3500",
            "fax_number": "708-581-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4507 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532621",
            "telephone_number": "708-581-3500",
            "fax_number": "708-581-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FJ HOME HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2017-02-02",
        "status": "A",
        "authorized_official_last_name": "TARIQ",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "708-581-3500"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "50270",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.