Excellent Care Health Services Inc
Organization Active NPI Home Health Agency · Roselle, IL
NPI 1447480751 · NPPES record last updated Dec 6, 2024
Key facts
- NPI
- 1447480751
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 1010965 (IL)
- Legal business name
- EXCELLENT CARE HEALTH SERVICES INC
- Practice address
- 400 Lake St Ste 306
Roselle, IL 60172-3573 - Phone
- (630) 893-9010
- Fax
- (630) 893-9017
- NPI assigned
- Jul 21, 2009
- Organization subpart
- No
Authorized official
- Name
- Ms. Sherry R Holmes, R.N
- Title
- Nursing Director
- Phone
- (630) 893-9010
Medicare Care Compare: Home health agency
- Listed as
- Excellent Care Health Services, Inc
- Overall star rating
- ★★★★☆ 3.5 of 5
- Ownership
- Proprietary
- Certified
- May 17, 2012
- 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 |
|---|---|---|---|
| 14D1102111 | Excellent Care Health Services Inc | Certificate of waiver | Jul 12, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Home health agency certification: CCN 148316
- Legal name
- EXCELLENT CARE HEALTH SERVICES INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- May 17, 2012
- Last certification
- Mar 26, 2021
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Incorporated
- Dec 12, 2007 in IL
- Enrollment address
- 400 Lake St
Ste 111a
Roselle, IL 60172-3571
All disclosed owners & managing parties 1
| Name | Role | Since | Share |
|---|---|---|---|
| Sherry Holmes |
5% Or Greater Direct Ownership Interest | Dec 28, 2019 | 100% |
| Corporate Director |
Sep 20, 2011 | 100% | |
| W-2 Managing Employee |
Sep 20, 2011 | 100% | |
| Operational/Managerial Control |
Sep 20, 2011 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110526000464 | IL | Part a Provider - Home Health Agency | 8921285024 | Practice locations: Roselle, IL |
National Provider Directory
Locations
5875 N Lincoln Ave
Lowr
Chicago, IL 60659
Phone (773) 275-5004
400 Lake St
Ste 306
Roselle, IL 60172
Phone (630) 893-9010
400 Lake St
Ste 111A
Roselle, IL 60172
Phone (630) 893-8300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 1010965 | IL | Yes |
Addresses
Primary practice location
400 Lake St Ste 306
Roselle, IL 60172-3573
Mailing address
400 Lake St Suite 111a
Roselle, IL 60172-3573
Phone (630) 893-9010
Other providers in Roselle, IL
- Dr. Duke Novak LLC
- Dr. Imran Ali P.C.
- Elder National in-Home Care LLC
- Ambreen Essani
- Daniel C. Evitts
- Amreen Farooqi
- Finite Dental LLC
- Catherine J Fitzgerald
- Foot and Ankle Institute of Illinois, LTD.
- Philip Forni
All providers in Roselle, 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 Dec 6, 2024. 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.