Immanuel Home Care Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

IMMANUEL HOME CARE SERVICES, INC.

Practice address

712 E 47TH St
Suite 301E
Chicago, IL 60653-4202

Phone

(773) 285-2227

Fax

(773) 285-3033

NPI assigned

Apr 10, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Irene Edwards Edwards, RN

Title

Administrator

Phone

(815) 577-7192

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Home health agency certification: CCN 148038

Legal name

IMMANUEL HOME CARE SERVICES, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 15, 2009

Last certification

Mar 26, 2021

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Jan 1, 2007 in IL

Enrollment address

9205 S Keating Ave
Ste 1
Oak Lawn, IL 60453-2583

Listed as

Immanuel Home Care Services, IncCCN 148038

Ownership

Proprietary

Certified

Mar 15, 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 2

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": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1194948976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 E 47TH ST",
            "address_2": "SUITE 301E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606534202",
            "telephone_number": "773-285-2227",
            "fax_number": "773-285-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 E 47TH ST",
            "address_2": "SUITE 301E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606534202",
            "telephone_number": "773-285-2227",
            "fax_number": "773-285-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMANUEL HOME CARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "IRENE",
        "authorized_official_middle_name": "EDWARDS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "815-577-7192",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Chicago, IL
• Providers in Chicago, 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 12, 2008; 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.