Custom Home Care, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1675283 Issued in IL

Legal business name

CUSTOM HOME CARE, INC.

Practice address

4754 N Lincoln Ave
2ND Floor
Chicago, IL 60625-2010

Phone

(773) 561-4663

Fax

(773) 561-2756

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Christy Prinz, RN, MSN

Title

President

Phone

(773) 561-4663

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407956550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2859 CENTRAL ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011234",
            "telephone_number": "773-561-4663",
            "fax_number": "773-561-2756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4754 N LINCOLN AVE",
            "address_2": "2ND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252010",
            "telephone_number": "773-561-4663",
            "fax_number": "773-561-2756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRINZ",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-561-4663",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, MSN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1675283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Chicago, IL
• Providers in Chicago, 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 Aug 22, 2020; 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.