Family Home Health Care Professionals Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1010772 Issued in IL

Legal business name

FAMILY HOME HEALTH CARE PROFESSIONALS INC

Practice address

3924 W Devon Ave Ste 100C&D
Lincolnwood, IL 60712-1040

Phone

(847) 779-3398

Fax

(847) 972-1025

NPI assigned

Oct 21, 2007

Organization subpart

No

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

Authorized official

Name

Gemma Bumanglag Jr.

Title

Administrator/Treasurer

Phone

(847) 779-3398

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Home health agency certification: CCN 148019

Legal name

FAMILY HOME HEALTH CARE PROFESSIONALS, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 28, 2008

Last certification

Oct 28, 2008

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Oct 3, 2006 in IL

Enrollment address

3924 W Devon Ave
Ste 101C&D
Lincolnwood, IL 60712-1040

Listed as

Family Home Health Care Professionals, IncCCN 148019

Overall star rating

1.5 of 5

Ownership

Proprietary

Certified

Oct 28, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

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.

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

{
    "created_epoch": "1192924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509667200000",
    "number": "1285823799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3924 W DEVON AVE STE 101C&D",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121040",
            "telephone_number": "847-779-3398",
            "fax_number": "847-972-1025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3924 W DEVON AVE STE 100C&D",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121040",
            "telephone_number": "847-779-3398",
            "fax_number": "847-972-1025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HOME HEALTH CARE PROFESSIONALS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-21",
        "last_updated": "2017-11-03",
        "status": "A",
        "authorized_official_last_name": "BUMANGLAG",
        "authorized_official_first_name": "GEMMA",
        "authorized_official_title_or_position": "ADMINISTRATOR/TREASURER",
        "authorized_official_telephone_number": "847-779-3398",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1010772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL DEPT OF PUBLIC HEALTH",
            "identifier": "1010772",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frederic Mark Ettner, M.D.
• Excel Care Health Services Inc
• Excellent Home Health Physicians Inc.
• Eye on Devon Inc.
• Camille Fabian, OTD
• Fastrack Medical Supplies,Inc.
• Daniel Matthew Faulk
• Lejla Fazlicic, LIC. AC
• Isroel Feiler, LPC
• Jamie Floersch, LCSW

• Home Health Agency in Lincolnwood, IL
• Providers in Lincolnwood, 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 Nov 3, 2017; 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.