Beverly Hills Home Services, Inc

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

3001377 Issued in IL

Legal business name

BEVERLY HILLS HOME SERVICES, INC

Practice address

10601 S. Longwood Drive
Chicago, IL 60643

Phone

(773) 474-6265

Fax

(773) 941-5366

NPI assigned

Dec 7, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Roselyn A San Juan

Title

President

Phone

(773) 457-6005

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571097600000",
    "number": "1417491671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10601 S. LONGWOOD DRIVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60643",
            "telephone_number": "773-474-6265",
            "fax_number": "773-941-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10601 S. LONGWOOD DRIVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60643",
            "telephone_number": "773-474-6265",
            "fax_number": "773-941-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY HILLS HOME SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-07",
        "last_updated": "2019-10-15",
        "status": "A",
        "authorized_official_last_name": "SAN JUAN",
        "authorized_official_first_name": "ROSELYN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-457-6005",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "IL",
            "license": "3001377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL DEPT. OF PUBLIC HEALTH HOME SERVICES ACCOUNT NUMBER",
            "identifier": "3001377",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Chicago, IL
• Providers in Chicago, IL by specialty
• In Home Supportive Care Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.