Active NPI
FJ Home Health Care Inc
- Home Health Agency
- Oak Lawn, IL
National Provider Identifier
1053445320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50270 | Other | IL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- 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 Inc
- Overall star rating
- Ownership
- Proprietary
- Certified
- Apr 4, 2003
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
National Provider Directory
National Provider DirectoryLocations
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Kamran Anis | W-2 Managing Employee | Dec 15, 2009 | 100% |
| Mubashir Ali Khan | 5% Or Greater Direct Ownership Interest | May 31, 2002 | 100% |
| Corporate Officer | May 31, 2002 | 100% | |
| Corporate Director | May 31, 2002 | 100% | |
| W-2 Managing Employee | May 31, 2002 | 100% | |
| Operational/Managerial Control | May 31, 2002 | 100% | |
| Sara Tariq | W-2 Managing Employee | 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.
-
- Occupational Therapist
- Evergreen Park, IL
- NPI 1649527672
-
- Physical Therapist
- Evergreen Park, IL
- NPI 1396024089
-
- Occupational Therapist
- Evergreen Park, IL
- NPI 1396006706
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.