Ico Care Home Health Inc.
Organization Active NPI Home Health Agency · Westchester, IL
NPI 1285873752 · NPPES record last updated Feb 6, 2009
Key facts
- NPI
- 1285873752
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- ICO CARE HOME HEALTH INC.
- Practice address
- 1107 S Mannheim Rd
Suite 212
Westchester, IL 60154-2561 - Phone
- (708) 343-4704
- Fax
- (708) 343-4941
- NPI assigned
- Feb 6, 2009
- Organization subpart
- No
Authorized official
- Name
- Mr. Sunday Nwankpa
- Title
- President/Ceo
- Phone
- (708) 781-3342
Practitioners 1
Affiliated clinicians 1
-
Ahmad Muhammad Salah, D.O
Medicare Care Compare: Home health agency
- Listed as
- Ico Care Home Health, Inc
- Ownership
- Proprietary
- Certified
- Oct 23, 2012
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Home health agency certification: CCN 148335
- Legal name
- ICO CARE HOME HEALTH INC.
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Oct 23, 2012
- Last certification
- Oct 23, 2012
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Incorporated
- Dec 31, 2007 in IL
- Enrollment address
- 4410 Roosevelt Road
Suite 201
Hillside, IL 60162-2000
All disclosed owners & managing parties 1
| Name | Role | Since | Share |
|---|---|---|---|
| Sunday Nwankpa |
5% Or Greater Direct Ownership Interest | Jul 26, 2010 | |
| W-2 Managing Employee | Jul 26, 2010 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101026000195 | IL | Part a Provider - Home Health Agency | 9032302732 | Practice locations: Hillside, IL |
National Provider Directory
Locations
4410 Roosevelt Rd
Ste 201
Hillside, IL 60162
Phone (708) 216-9803
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
1107 S Mannheim Rd
Suite 212
Westchester, IL 60154-2561
Mailing address
1107 S Mannheim Rd
Suite 212
Westchester, IL 60154-2561
Phone (708) 343-4704
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All providers in Westchester, IL · Home Health Agency in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.