Affinity Home Health Services, Inc.
Organization Active NPI Home Health Agency · Harwood Heights, IL
NPI 1437301751 · NPPES record last updated Oct 17, 2008
Key facts
- NPI
- 1437301751
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 1010937 (IL)
- Legal business name
- AFFINITY HOME HEALTH SERVICES, INC.
- Practice address
- 7151 W Gunnison St
Suite 103
Harwood Heights, IL 60706-3800 - Phone
- (708) 867-7902
- Fax
- (708) 867-7952
- NPI assigned
- Oct 17, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. Julio C Delos Reyes, R.N.
- Title
- Agency Supervisor
- Phone
- (708) 867-7902
Affiliated clinicians 1
-
Rodney H Berger, M.D.
Medicare Care Compare: Home health agency
- Listed as
- Affinity Home Health Services, Inc
- Ownership
- Proprietary
- Certified
- Nov 21, 2009
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D1079112 | Affinity Home Health Services Inc | Certificate of waiver | Aug 13, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Home health agency certification: CCN 148104
- Legal name
- AFFINITY HOME HEALTH SERVICES, INC.
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Nov 21, 2009
- Last certification
- Jul 29, 2021
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Incorporated
- Mar 23, 2007 in IL
- Enrollment address
- 7125 W Gunnison St
Ste 206
Harwood Heights, IL 60706-3830
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Julio Delos Reyes |
5% Or Greater Direct Ownership Interest | Dec 15, 2023 | 51% |
| Corporate Director | Dec 15, 2023 | 51% | |
| W-2 Managing Employee | Nov 1, 2008 | ||
| Maria de Vera |
5% Or Greater Direct Ownership Interest | Dec 15, 2023 | 49% |
| Corporate Director | Dec 15, 2023 | 49% | |
| Paul a Delos-Reyes |
Corporate Director | Dec 10, 2012 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090319000524 | IL | Part a Provider - Home Health Agency | 4284791161 | Practice locations: Harwood Heights, IL |
National Provider Directory
Locations
7125 W Gunnison St
Ste 206
Harwood Heights, IL 60706
Phone (708) 867-7902
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 1010937 | IL | Yes |
Addresses
Primary practice location
7151 W Gunnison St
Suite 103
Harwood Heights, IL 60706-3800
Mailing address
7151 W Gunnison St
Suite 103
Harwood Heights, IL 60706-3800
Phone (708) 867-7902
Other providers in Harwood Heights, IL
- Zakaria Abdelhalim
- Mark Joseph Anderko Sr.
- Angel Caregivers Inc
- Angel Caregivers Inc.
- Christin Anzalotti
- Nicole Arias
All providers in Harwood Heights, IL · Home Health Agency in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.