Supreme Home Health Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1010559 Issued in IL

Legal business name

SUPREME HOME HEALTH INC

Practice address

2625 Butterfield Rd
Suite 128N
Oak Brook, IL 60523-1234

Phone

(630) 945-9200

Fax

(630) 945-9204

NPI assigned

May 18, 2006

Last updated

Aug 22, 2020By 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

Jesusa Buniao

Title

Administrator

Phone

(630) 945-9200

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 1316990815. Details of each certification follow.

• CCN 147893 Home health agency · Active · Details

Home health agency certification: CCN 147893

Legal name

SUPREME HOME HEALTH INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Aug 21, 2006

Last certification

Nov 12, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Aug 23, 2005 in IL

Enrollment address

2625 Butterfield Rd
Ste 132N
Oak Brook, IL 60523-3410

Listed as

Supreme Home Health, IncCCN 147893 · All quality measures

Overall star rating

1.5 of 5

Ownership

Proprietary

Certified

Aug 21, 2006

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 2

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

Affiliated clinicians 4

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

• Ahmed Hussain Memon, NP

  • Nurse Practitioner
  • Chicago, IL
  • NPI 1033693742

  Home health agency

  Care Compare affiliation
• Bilquis Mohammed, FNP

  • Family Nurse Practitioner
  • Schaumburg, IL
  • NPI 1801148580

  Home health agency

  Care Compare affiliation
• J. Romaine Roberts, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Chicago, IL
  • NPI 1376528802

  Home health agency

  Care Compare affiliation
• Gary Rodriguez, M.D.

  • Family Medicine Physician
  • Berwyn, IL
  • NPI 1447646641

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316990815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD",
            "address_2": "SUITE 128N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231234",
            "telephone_number": "630-945-9200",
            "fax_number": "630-945-9204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD",
            "address_2": "SUITE 128N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231234",
            "telephone_number": "630-945-9200",
            "fax_number": "630-945-9204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUNIAO",
        "authorized_official_first_name": "JESUSA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "630-945-9200"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1010559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Oak Brook, IL
• Providers in Oak Brook, 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 Aug 22, 2020; 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.