Organization Active NPI

Wellbound Illinois LLC

  • Home Health Agency
  • Park Ridge, IL
National Provider Identifier
1104781640
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
WELLBOUND ILLINOIS LLC
Practice address
1420 Renaissance Dr Ste 400
Park Ridge, IL 60068-1345
Phone
(718) 400-9355
NPI assigned
Dec 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Authorized official

Name
Adam Yanofsky
Title
Ceo
Phone
(718) 400-9355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1420 Renaissance Dr Ste 400
Park Ridge, IL 60068-1345

Mailing address

7424 13TH Ave
Brooklyn, NY 11228-2021

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260312001728 IL Part A Provider - Home Health Agency 8325521883 Practice locations: Park Ridge, IL

Home health agency certification: CCN 148344

Legal name
WELLBOUND ILLINOIS LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 22, 2013
Last certification
Jan 22, 2013
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
1420 Renaissance Dr
Ste 400
Park Ridge, IL 60068-1345

Care Compare: Home health agency

Medicare Care Compare
Listed as
Wellbound Illinois LLCCCN 148344 · All quality measures
Ownership
Proprietary
Certified
Jan 22, 2013
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

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Wellbound III LLC Organization, Brooklyn, NY Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 15, 2025 100%
Adam Yan0Fsky Individual Corporate OfficerChief Executive Officer Dec 15, 2025 100%
Raphael Weiss Individual 5% Or Greater Indirect Ownership InterestTreasurer Dec 15, 2025 50%
Corporate OfficerTreasurer Dec 15, 2025 50%
Laura Ravago Individual W-2 Managing EmployeeAd; Dec 15, 2025 100%
Robert Snyder Individual 5% Or Greater Indirect Ownership InterestPresident Dec 15, 2025 50%
Corporate OfficerPresident Dec 15, 2025 50%

Change-of-ownership history 1

DateEventCounterparty
Dec 15, 2025 Change of OwnershipThis provider was the buyer 1St Choice Home Health Providers LLCCCN 148344, IL, NPI 1821361759

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1765929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765929600000",
    "number": "1104781640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7424 13TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112282021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 RENAISSANCE DR STE 400",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681345",
            "telephone_number": "718-400-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLBOUND ILLINOIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-17",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A",
        "authorized_official_last_name": "YANOFSKY",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-400-9355"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.