NPIMap

Organization Active NPI

Bay Group Health Care LLC

  • Home Health Agency
  • Chicago, IL
National Provider Identifier
1063441996
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1010557 Issued in IL
Legal business name
BAY GROUP HEALTH CARE LLC
Practice address
6160 N Cicero Ave
Suite 104
Chicago, IL 60646-4312
Phone
(773) 282-9610
Fax
(773) 282-9615
NPI assigned
Jul 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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

Authorized official

Name
Mr. Max Azarov
Title
Alt. Administrator
Phone
(219) 629-5492

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 1010557 IL Primary

Addresses

Primary practice location

6160 N Cicero Ave
Suite 104
Chicago, IL 60646-4312

Mailing address

6160 N Cicero Ave
Suite 104
Chicago, IL 60646-4312
Phone (773) 282-9610

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060907000107 IL Part A Provider - Home Health Agency 9133123094 Practice locations: Arlington Heights, IL

Home health agency certification: CCN 147914

Legal name
BAY GROUP HEALTH CARE , LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 8, 2006
Last certification
Apr 7, 2012
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Sep 1, 2005 in IL
Enrollment address
2045 S Arlington Heights Rd
Ste 108a
Arlington Heights, IL 60005-4151

Care Compare: Home health agency

Medicare Care Compare
Listed as
Bay Group Health Care, LLCCCN 147914
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Dec 8, 2006
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy

National Provider Directory

National Provider Directory

Locations

2045 S Arlington Heights Rd
Ste 108A
Arlington Heights, IL 60005
Phone (224) 534-3400

6160 N Cicero Ave
Ste 104
Chicago, IL 60646
Phone (773) 282-9610

8170 McCormick Blvd
Ste 210
Skokie, IL 60076
Phone (224) 534-3400

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
Wilbert T Tan Individual 5% Or Greater Direct Ownership Interest Nov 16, 2017 33.3%
Corporate OfficerAsmin Nov 16, 2017 33.3%
W-2 Managing EmployeeAdmin Nov 16, 2017 33.3%
Riza G Acas Individual 5% Or Greater Direct Ownership Interest Nov 16, 2017 33.3%
Eden C Estella Individual 5% Or Greater Direct Ownership Interest Nov 16, 2017 33.3%

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205884800000",
    "number": "1063441996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6160 N CICERO AVE",
            "address_2": "SUITE 104",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606464312",
            "telephone_number": "773-282-9610",
            "fax_number": "773-282-9615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 N CICERO AVE",
            "address_2": "SUITE 104",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606464312",
            "telephone_number": "773-282-9610",
            "fax_number": "773-282-9615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY GROUP HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2008-03-19",
        "status": "A",
        "authorized_official_last_name": "AZAROV",
        "authorized_official_first_name": "MAX",
        "authorized_official_title_or_position": "ALT. ADMINISTRATOR",
        "authorized_official_telephone_number": "219-629-5492",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1010557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.