Pro Vita Home Care, LLC.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1010672 Issued in IL

Legal business name

PRO VITA HOME CARE, LLC.

Practice address

5875 N Lincoln Ave
Suite 224
Chicago, IL 60659-4668

Phone

(773) 275-2190

Fax

(773) 275-2195

NPI assigned

Jan 23, 2007

Last updated

Jul 18, 2008By 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

Rodel Bugayong, RN

Title

Administrator

Phone

(773) 275-2190

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216339200000",
    "number": "1225182280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5875 N LINCOLN AVE",
            "address_2": "SUITE 224",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594668",
            "telephone_number": "773-275-2190",
            "fax_number": "773-275-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 N LINCOLN AVE",
            "address_2": "SUITE 224",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594668",
            "telephone_number": "773-275-2190",
            "fax_number": "773-275-2195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO VITA HOME CARE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2008-07-18",
        "status": "A",
        "authorized_official_last_name": "BUGAYONG",
        "authorized_official_first_name": "RODEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "773-275-2190",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1010672",
            "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 Jul 18, 2008; 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.