Specialized Homecare Services

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SPECIALIZED HOMECARE SERVICES

Practice address

19900 Governors Dr
Suite 13
Olympia Fields, IL 60461-1057

Phone

(708) 663-8782

NPI assigned

Mar 2, 2016

Organization subpart

No

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

Authorized official

Name

Lakisha D Jelks

Title

Manager/Certified Nurse Assistant

Phone

(708) 965-9758

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456876800000",
    "number": "1346600467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 223",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604380223",
            "telephone_number": "708-965-9758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19900 GOVERNORS DR",
            "address_2": "SUITE 13",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611057",
            "telephone_number": "708-663-8782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED HOMECARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-02",
        "last_updated": "2016-03-02",
        "status": "A",
        "authorized_official_last_name": "JELKS",
        "authorized_official_first_name": "LAKISHA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGER/CERTIFIED NURSE ASSISTANT",
        "authorized_official_telephone_number": "708-965-9758"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.