Chicagoland Home Health Provider, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

101104 Issued in IL

Legal business name

CHICAGOLAND HOME HEALTH PROVIDER, INC.

Practice address

2604 Dempster St
Suite 508
Park Ridge, IL 60068-8412

Phone

(847) 296-3950

Fax

(847) 296-3955

NPI assigned

Dec 12, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Evelyn A. Saplala

Title

Administrator

Phone

(847) 296-3950

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Home health agency certification: CCN 147854

Legal name

CHICAGOLAND HOME HEALTH PROVIDER, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Feb 21, 2006

Last certification

Dec 6, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Oct 8, 2004 in IL

Enrollment address

1974 Miner St
Unit 101
Des Plaines, IL 60016-4714
HHA Branch

Listed as

Chicagoland Home Health Provider, IncCCN 147854

Overall star rating

2 of 5

Ownership

Proprietary

Certified

Feb 21, 2006

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

Tax ID family

Chicagoland Home Health Provider Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Chicagoland Home Health Provider, Inc.

  • Home Health Agency
  • Park Ridge, IL
  • NPI 1215975388
  NPD tax ID

Locations

All disclosed owners & managing parties 1

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

Affiliated clinicians 1

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

• Bino Varghese Oommen, M.D.

  • Internal Medicine Physician
  • Des Plaines, IL
  • NPI 1235315995

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381449600000",
    "number": "1326109448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 DEMPSTER ST",
            "address_2": "SUITE 508",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600688412",
            "telephone_number": "847-296-3950",
            "fax_number": "847-296-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 DEMPSTER ST",
            "address_2": "SUITE 508",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600688412",
            "telephone_number": "847-296-3950",
            "fax_number": "847-296-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGOLAND HOME HEALTH PROVIDER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2013-10-11",
        "status": "A",
        "authorized_official_last_name": "SAPLALA",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "847-296-3950",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1677304",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "101104",
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1010421",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• David Tian Chin, M.D.
• Kristy Chin

• Home Health Agency in Park Ridge, IL
• Providers in Park Ridge, 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 Oct 11, 2013; 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.