NPIMap

Organization Active NPI

Wellcare Home Health Inc

  • Home Health Agency
  • Northbrook, IL
National Provider Identifier
1407933914
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1010446 Issued in IL
Legal business name
WELLCARE HOME HEALTH INC
Practice address
3605 Woodhead Dr
Suite 107
Northbrook, IL 60053
Phone
(847) 562-4041
Fax
(847) 562-4042
NPI assigned
Nov 1, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Rena Artman, RN
Title
Administrator
Phone
(847) 562-4041

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 1010446 IL Primary

Addresses

Primary practice location

3605 Woodhead Dr
Suite 107
Northbrook, IL 60053

Mailing address

3605 Woodhead Dr
Suite 107
Northbrook, IL 60053
Phone (847) 562-4041

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060112000130 IL Part A Provider - Home Health Agency 2062435373 Practice locations: Northbrook, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407933914. Details of each certification follow.

Home health agency certification: CCN 147835

Legal name
WELLCARE HOME HEALTH INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 7, 2005
Last certification
Jan 13, 2017
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Enrollment address
3340 Dundee Rd
Ste 2C3
Northbrook, IL 60062-2331

Care Compare: Home health agency

Medicare Care Compare
Listed as
Wellcare Home Health, IncCCN 147835 · All quality measures
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Nov 7, 2005
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
14D1038593Wellcare Home Health Inc3340 Dundee Rd, Ste 2C3, Northbrook, IL 60062Certificate of waiverMar 22, 2027

National Provider Directory

National Provider Directory

Locations

3340 Dundee Rd
Ste 2C3
Northbrook, IL 60062
Phone (847) 562-4041

3605 Woodhead Dr
Ste 107
Northbrook, IL 60062
Phone (847) 562-4041

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
Marina Shved Individual 5% Or Greater Direct Ownership Interest Jan 7, 2005 33.33%
Corporate OfficerVP and Board Member Jan 7, 2005 33.33%
Corporate Director Jan 7, 2005 33.33%
W-2 Managing EmployeeAd; Jan 7, 2005 50%
Irina Maslovsky Individual 5% Or Greater Direct Ownership Interest Jan 1, 2019 16.5%
Boris Maslovsky Individual 5% Or Greater Direct Ownership Interest Jan 1, 2019 16.5%
Rena Artman Individual 5% Or Greater Direct Ownership Interest Jan 7, 2005 33.33%
Corporate OfficerPresident and Board Member Jan 7, 2005 33.33%
Corporate Director Jan 7, 2005 33.33%
W-2 Managing EmployeeDirector of Nursing Agency Supervis Jan 7, 2005 50%

Practitioners & affiliated clinicians

Affiliated clinicians 11

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407933914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 WOODHEAD DR",
            "address_2": "SUITE 107",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "60053",
            "telephone_number": "847-562-4041",
            "fax_number": "847-562-4042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 WOODHEAD DR",
            "address_2": "SUITE 107",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "60053",
            "telephone_number": "847-562-4041",
            "fax_number": "847-562-4042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLCARE HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ARTMAN",
        "authorized_official_first_name": "RENA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "847-562-4041",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1010446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.