Healthsource Home Care, Inc.

Primary specialty

HomemakerTaxonomy code 376J00000X

License

8421173 Issued in IL

Legal business name

HEALTHSOURCE HOME CARE, INC.

Practice address

2863 95TH St Ste 143-376
Naperville, IL 60564

Phone

(630) 390-0190

Fax

(630) 622-1515

NPI assigned

Nov 14, 2006

Last updated

Jul 24, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Peter Chung

Title

Administrator

Phone

(630) 390-0190

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Catherine L Chung, APN

  • Family Nurse Practitioner
  • Chicago, IL
  • NPI 1003325267
  NPD

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532390400000",
    "number": "1114099470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2863 95TH ST STE 143-376",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605649005",
            "telephone_number": "630-390-0190",
            "fax_number": "630-810-5725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2863 95TH ST STE 143-376",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "60564",
            "telephone_number": "630-390-0190",
            "fax_number": "630-622-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2018-07-24",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "630-390-0190"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1010593",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1011070",
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": "IL",
            "license": "8421173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8421173",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Homemaker in Naperville, IL
• Providers in Naperville, IL by specialty
• Homemaker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.