I J Healthcare Nursing Resource LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1010445 Issued in IL

Legal business name

I J HEALTHCARE NURSING RESOURCE LLC

Practice address

8200 185TH St Ste H14
Tinley Park, IL 60487-9308

Phone

(708) 620-8599

Fax

(708) 620-8874

NPI assigned

May 20, 2006

Last updated

Jul 21, 2022By 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

Ms. Jolly Samuel, RN

Title

Owner

Phone

(708) 620-8599

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 1316991573. Details of each certification follow.

• CCN 147939 Home health agency · Active · Details

Home health agency certification: CCN 147939

Legal name

I J HEALTHCARE NURSING RESOURCE LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 14, 2007

Last certification

May 20, 2021

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Apr 22, 2005 in IL

Enrollment address

8200 W. 185TH Street
Suite H-14
Tinley Park, IL 60487-9308

Listed as

I J Healthcare Nursing Resource IncCCN 147939 · All quality measures

Overall star rating

1.5 of 5

Ownership

Proprietary

Certified

Mar 14, 2007

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 3

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

Affiliated clinicians 2

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

• Srinivas-Prasad Reddy Jolepalem, M.D.

  • Internal Medicine Physician
  • Darien, IL
  • NPI 1568531564

  Home health agency

  Care Compare affiliation
• Ernestine Monica Koehn, FNP-BC

  • Family Nurse Practitioner
  • Mount Prospect, IL
  • NPI 1467710046

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1316991573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8130 APACHE TRL",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604776530",
            "telephone_number": "708-620-8599",
            "fax_number": "708-620-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 185TH ST STE H14",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604879308",
            "telephone_number": "708-620-8599",
            "fax_number": "708-620-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I J HEALTHCARE NURSING RESOURCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SAMUEL",
        "authorized_official_first_name": "JOLLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-620-8599",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1010445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Nicole Hunley Brookins
• Brett Henry Hurliman, M.D.
• Maryam Hussain
• Leeann Hussein
• Katie Huynh
• Kathleen Lynn Ibarra, LCSW, CADC
• Ibrahim MD SC
• Ibrahim MD SC
• Hassan A Ibrahim, M.D.
• Kareem Ibrahim, APRN

• Home Health Agency in Tinley Park, IL
• Providers in Tinley Park, 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 Jul 21, 2022; 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.