Community Care Home Health Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

COMMUNITY CARE HOME HEALTH SERVICES, INC.

Practice address

10001 Derby LN
Suite 207
Westchester, IL 60154-2600

Phone

(708) 410-2605

Fax

(708) 410-2601

NPI assigned

Sep 19, 2007

Last updated

Mar 11, 2009By 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

Mrs. Maryliza Lorenzo, RN

Title

Administrator

Phone

(708) 410-2605

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194911636. Details of each certification follow.

• CCN 148075 Home health agency · Active · Details

Home health agency certification: CCN 148075

Legal name

COMMUNITY CARE HOME HEALTH SERVICES, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Sep 25, 2009

Last certification

Sep 25, 2009

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Enrollment address

1001 Ogden Ave
Ste 201
Downers Grove, IL 60515-2871

Listed as

Community Care Home Health Services, IncCCN 148075 · All quality measures

Overall star rating

1.5 of 5

Ownership

Proprietary

Certified

Sep 25, 2009

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

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

Affiliated clinicians 5

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

• Kaamilya T James, PA-C

  • Medical Physician Assistant
  • Oak Park, IL
  • NPI 1376652370

  Home health agency

  Care Compare affiliation
• Thomas Venkat Mallidi, MD

  • Family Medicine Physician
  • Hinsdale, IL
  • NPI 1588924278

  Home health agency

  Care Compare affiliation
• Patricia Ann McCann, APN

  • Adult Health Nurse Practitioner
  • La Grange, IL
  • NPI 1588957013

  Home health agency

  Care Compare affiliation
• Arshea Siddiqui, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Aurora, IL
  • NPI 1184670671

  Home health agency

  Care Compare affiliation
• Shahaab Uddin, M.D.

  • Internal Medicine Physician
  • New Albany, IN
  • NPI 1669784872

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236729600000",
    "number": "1194911636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 DERBY LN",
            "address_2": "SUITE 207",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601543749",
            "telephone_number": "708-410-2605",
            "fax_number": "708-410-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 DERBY LN",
            "address_2": "SUITE 207",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601542600",
            "telephone_number": "708-410-2605",
            "fax_number": "708-410-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE HOME HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2009-03-11",
        "status": "A",
        "authorized_official_last_name": "LORENZO",
        "authorized_official_first_name": "MARYLIZA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "708-410-2605",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Westchester, IL
• Providers in Westchester, IL by specialty
• Home Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2009; 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.