Meritcare Home Health Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MERITCARE HOME HEALTH INC

Practice address

4830 W Jarlath St
Lincolnwood, IL 60712-1616

Phone

(773) 939-6190

Fax

(224) 534-7459

NPI assigned

Oct 17, 2023

Organization subpart

No

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

Authorized official

Name

Bede Maravilla

Title

Administrator

Phone

(224) 534-7462

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Home health agency certification: CCN 148423

Legal name

MERITCARE HOME HEALTH INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Dec 26, 2024

Last certification

Dec 5, 2024

Organization structure

CorporationProprietary

Incorporated

Apr 21, 2005 in IL

Enrollment address

5940 W Touhy Ave
Ste 185 a
Niles, IL 60714-4642

Listed as

Meritcare Home Health IncCCN 148423

Ownership

-

Certified

Dec 26, 2024

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 1

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

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

{
    "created_epoch": "1697500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1114709987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4830 W JARLATH ST",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121616",
            "telephone_number": "773-939-6190",
            "fax_number": "224-534-7459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4830 W JARLATH ST",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121616",
            "telephone_number": "773-939-6190",
            "fax_number": "224-534-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERITCARE HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "MARAVILLA",
        "authorized_official_first_name": "BEDE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "224-534-7462"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; 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.

Verify at the official NPI Registry.