NPIMap

Organization Active NPI

Medic Home Health Care, LLC

  • Home Health Agency
  • Bolingbrook, IL
National Provider Identifier
1063722940
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1011325 Issued in IL
Legal business name
MEDIC HOME HEALTH CARE, LLC
Practice address
109 Royce Rd Ste D
Bolingbrook, IL 60440-1405
Phone
(888) 207-6250
Fax
(888) 207-6251
NPI assigned
Oct 13, 2010
Last updated
May 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Authorized official

Name
Ms. Rica Mirella Somoza, RN
Title
Agency Supervisor
Phone
(888) 207-6250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 1011325 IL Primary

Addresses

Primary practice location

109 Royce Rd Ste D
Bolingbrook, IL 60440-1405

Mailing address

109 Royce Rd Ste D
Bolingbrook, IL 60440-1405
Phone (888) 207-6250

Other identifiers 1

IdentifierTypeStateIssuer
1011325OtherILILLINOIS DEPARTMENT OF HEALTH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110103000678 IL Part A Provider - Home Health Agency 9234327479 Practice locations: Bolingbrook, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063722940. Details of each certification follow.

Home health agency certification: CCN 148278

Legal name
MEDIC HOME HEALTH CARE, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 14, 2011
Last certification
Nov 14, 2011
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Dec 5, 2006 in IL
Enrollment address
109 Royce Rd
Ste D
Bolingbrook, IL 60440-1405

Care Compare: Home health agency

Medicare Care Compare
Listed as
Medic Home Health Care, LLCCCN 148278 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Nov 14, 2011
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

109 Royce Rd
Ste D
Bolingbrook, IL 60440
Phone (888) 207-6250

550 E Boughton Rd
Ste 220
Bolingbrook, IL 60440
Phone (888) 207-6250

6912 Main St
Ste 105
Downers Grove, IL 60516
Phone (888) 207-6250

906 Lacey Ave
Ste 109
Lisle, IL 60532
Phone (630) 729-9649

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Rica Somoza Individual 5% Or Greater Direct Ownership Interest Nov 24, 2010
Corporate Director Nov 24, 2010
W-2 Managing Employee Nov 24, 2010
Jhoana Somoza Individual 5% Or Greater Direct Ownership Interest Nov 24, 2010
Corporate Director Nov 24, 2010
W-2 Managing Employee Nov 24, 2010
Rico Somoza Individual 5% Or Greater Direct Ownership Interest Nov 24, 2010
Corporate Director Nov 24, 2010
W-2 Managing Employee Nov 24, 2010
Medic Home Health Care, LLC Organization, Downers Grove, IL LLC 5% Or Greater Direct Ownership Interest Nov 24, 2010

Practitioners & affiliated clinicians

Affiliated clinicians 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685491200000",
    "number": "1063722940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 ROYCE RD STE D",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401405",
            "telephone_number": "888-207-6250",
            "fax_number": "888-207-6251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 ROYCE RD STE D",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401405",
            "telephone_number": "888-207-6250",
            "fax_number": "888-207-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIC HOME HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-13",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A",
        "authorized_official_last_name": "SOMOZA",
        "authorized_official_first_name": "RICA",
        "authorized_official_middle_name": "MIRELLA",
        "authorized_official_title_or_position": "AGENCY SUPERVISOR",
        "authorized_official_telephone_number": "888-207-6250",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1011325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS DEPARTMENT OF HEALTH",
            "identifier": "1011325",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.