Advance Home Health Care Provider Corporation

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

IL1010800 Issued in IL

Legal business name

ADVANCE HOME HEALTH CARE PROVIDER CORPORATION

Practice address

935 W 175TH Street
Suite 102
Homewood, IL 60430

Phone

(630) 424-9400

Fax

(630) 424-9421

NPI assigned

Oct 6, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Mir M Mirjat

Title

Administrator

Phone

(630) 424-9400

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Home health agency certification: CCN 148071

Legal name

ADVANCE HOME HEALTH CARE PROVIDER CORPORATION

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jan 29, 2009

Last certification

Mar 12, 2021

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Dec 8, 2006 in IL

Enrollment address

935 W. 175TH St
Ste 102
Homewood, IL 60430-2073

Listed as

Advance Home Health Care Provider CorpCCN 148071

Overall star rating

3.5 of 5

Ownership

Proprietary

Certified

Jan 29, 2009

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 2

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

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Rabia Naveed, M.D.

  • Family Medicine Physician
  • Batavia, IL
  • NPI 1134351604

  5% Or Greater Direct Ownership Interest, 5% Or Greater Indirect Ownership Interest, Corporate Director, General Partnership Interest

  CMS ownership
• Syed Raziuddin Majid, MD, FRCP, FASAM

  • Internal Medicine Physician
  • San Jose, CA
  • NPI 1225009533

  5% Or Greater Direct Ownership Interest, Corporate Director, General Partnership Interest, W-2 Managing Employee

  CMS ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Syed Raziuddin Majid, MD, FRCP, FASAM

  • Internal Medicine Physician
  • San Jose, CA
  • NPI 1225009533
  NPD
• Rabia Naveed, M.D.

  • Family Medicine Physician
  • Batavia, IL
  • NPI 1134351604
  NPD (past)

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

{
    "created_epoch": "1191628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572220800000",
    "number": "1336337138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 W 175TH STREET",
            "address_2": "SUITE 102",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "60430",
            "telephone_number": "630-424-9400",
            "fax_number": "630-424-9421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 W 175TH STREET",
            "address_2": "SUITE 102",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "60430",
            "telephone_number": "630-424-9400",
            "fax_number": "630-424-9421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE HOME HEALTH CARE PROVIDER CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-06",
        "last_updated": "2019-10-28",
        "status": "A",
        "authorized_official_last_name": "MIRJAT",
        "authorized_official_first_name": "MIR",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "630-424-9400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "IL1010800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDPH",
            "identifier": "IL1010800",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Homewood, IL
• Providers in Homewood, 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 28, 2019; 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.