Active NPI
Wellbound Illinois LLC
- Home Health Agency
- Park Ridge, IL
National Provider Identifier
1104781640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- LLC
- Enrollment address
- 1420 Renaissance Dr
Ste 400
Park Ridge, IL 60068-1345
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Wellbound Illinois LLC
- Ownership
- Proprietary
- Certified
- Jan 22, 2013
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Wellbound III LLC | 5% Or Greater Direct Ownership Interest | Dec 15, 2025 | 100% |
| Adam Yan0Fsky | Corporate Officer | Dec 15, 2025 | 100% |
| Raphael Weiss | 5% Or Greater Indirect Ownership Interest | Dec 15, 2025 | 50% |
| Corporate Officer | Dec 15, 2025 | 50% | |
| Laura Ravago | W-2 Managing Employee | Dec 15, 2025 | 100% |
| Robert Snyder | 5% Or Greater Indirect Ownership Interest | Dec 15, 2025 | 50% |
| Corporate Officer | Dec 15, 2025 | 50% |
Change-of-ownership history 1
| Date | Event | Counterparty |
|---|---|---|
| Dec 15, 2025 | Change of Ownership | 1St Choice Home Health Providers LLC |
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; 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.