NPIMap

Organization Active NPI

Sunny Hill Home Health Care, Inc.

  • Home Health Agency
  • Oak Lawn, IL
National Provider Identifier
1366651077
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SUNNY HILL HOME HEALTH CARE, INC.
Practice address
4632 W 105TH PL
Oak Lawn, IL 60453-5210
Phone
(708) 424-7025
Fax
(708) 424-8003
NPI assigned
May 21, 2007
Last updated
Jan 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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

Authorized official

Name
Mrs. Ingrid Izurieta
Title
Administrator
Phone
(708) 424-7025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

4632 W 105TH PL
Oak Lawn, IL 60453-5210

Mailing address

10220 S Cicero Ave Ste 201
Oak Lawn, IL 60453-4086
Phone (708) 424-7025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080508000146 IL Part A Provider - Home Health Agency 7315026937 Practice locations: Oak Lawn, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366651077. Details of each certification follow.

Home health agency certification: CCN 148058

Legal name
SUNNY HILL HOME HEALTH CARE, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 23, 2009
Last certification
Jan 23, 2009
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Enrollment address
10220 S Cicero Avenue
Suite 201
Oak Lawn, IL 60453-5210

Care Compare: Home health agency

Medicare Care Compare
Listed as
Sunny Hill Home Health Care, IncCCN 148058 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Jan 23, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D1074098Sunny Hill Home Health Care Inc10220 S Cicero Ave, Ste 201, Oak Lawn, IL 60453Certificate of waiverSep 23, 2027

National Provider Directory

National Provider Directory

Locations

10220 S Cicero Ave
Ste 201
Oak Lawn, IL 60453
Phone (708) 424-7025

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Visitacion Hicks Individual 5% Or Greater Direct Ownership Interest Mar 15, 2007 20%
Lolita Ranchero Individual 5% Or Greater Direct Ownership Interest Mar 15, 2007 20%
Ingrid Izurieta Villaneva Individual 5% Or Greater Direct Ownership InterestCeo,Board Member Mar 15, 2007 50%
Corporate OfficerCeo.Board Member Mar 15, 2007 50%
Corporate DirectorCeo, Board Member Mar 15, 2007 50%
W-2 Managing EmployeeCeo,Board Member Mar 15, 2007 50%
Operational/Managerial ControlCeo. Board Member Mar 15, 2007 50%
E Geovanni Izurieta Individual 5% Or Greater Direct Ownership Interest Apr 1, 2012
Corporate OfficerBoard Member Apr 1, 2012 10%
Corporate DirectorBoard Member Apr 1, 2012 10%
W-2 Managing Employee Oct 1, 2009 10%

Practitioners & affiliated clinicians

Affiliated clinicians 9

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

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547683200000",
    "number": "1366651077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10220 S CICERO AVE STE 201",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604534086",
            "telephone_number": "708-424-7025",
            "fax_number": "708-424-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4632 W 105TH PL",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535210",
            "telephone_number": "708-424-7025",
            "fax_number": "708-424-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNY HILL HOME HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2019-01-17",
        "status": "A",
        "authorized_official_last_name": "IZURIETA",
        "authorized_official_first_name": "INGRID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "708-424-7025",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.