Vanguard Health & Wellness LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

VANGUARD HEALTH & WELLNESS LLC

Practice address

1585 Ellinwood Ave
Suite 100
Des Plaines, IL 60016-4510

Phone

(855) 438-2431

NPI assigned

Jan 26, 2011

Last updated

Oct 11, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Alexander Green

Title

Administrator

Phone

(855) 438-2431

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477858298. Details of each certification follow.

• CCN 148311 Home health agency · Active · Details

Home health agency certification: CCN 148311

Legal name

VANGUARD HEALTH & WELLNESS LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

May 16, 2012

Last certification

Apr 29, 2021

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Jan 14, 2011 in IL

Enrollment address

1585 Ellinwood Ave
Ste 100
Des Plaines, IL 60016-4510

Listed as

Vanguard Health & Wellness, LLCCCN 148311 · All quality measures

Overall star rating

3.5 of 5

Ownership

Proprietary

Certified

May 16, 2012

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Ronald Anthony Hickombottom, M.D

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1023020989

  Home health agency

  Care Compare affiliation
• Audrey R. Hiltunen, MD

  • Internal Medicine Physician
  • Maywood, IL
  • NPI 1679004824

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665446400000",
    "number": "1477858298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 ELLINWOOD AVE",
            "address_2": "SUITE 100",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600164510",
            "telephone_number": "855-438-2431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 ELLINWOOD AVE",
            "address_2": "SUITE 100",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600164510",
            "telephone_number": "855-438-2431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANGUARD HEALTH & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-26",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "855-438-2431",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salih Uzun, MD
• Alexandra Vacha, BCBA
• Christina Valdivia, APRN
• Alizabeth Grace-Neu Van Wieren, PA-C
• Malcolm Marazban Vandrevala, M.D.
• Katerina Diane Vaselopulos
• Kelly M. Vasquez, APN-CNP
• Vax2Health, PLLC
• Vcare Pharmacy Inc (Vcare Pharmacy)
• Mia Vela

• Home Health Agency in Des Plaines, IL
• Providers in Des Plaines, 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 Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.