Great Paragon Health Care Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1010583 Issued in IL

Legal business name

GREAT PARAGON HEALTH CARE INC.

Practice address

2640 W Touhy Ave
Ste. 205-206
Chicago, IL 60645-3198

Phone

(773) 274-7694

Fax

(773) 274-9082

NPI assigned

Aug 10, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Aiwuyo Rita Obaseki, RN

Title

Director/Administrator

Phone

(773) 274-7694

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Home health agency certification: CCN 148122

Legal name

GREAT PARAGON HEALTH CARE INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Dec 7, 2009

Last certification

Dec 7, 2009

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

May 5, 2003 in IL

Enrollment address

2640 W. Touhy
Suite 205-206
Chicago, IL 60645-3198

Listed as

Great Paragon Healthcare, IncCCN 148122 · All quality measures

Ownership

Proprietary

Certified

Dec 7, 2009

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

Tax ID family

Great Paragon Health Care Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Great Paragon Health Care Inc.

  • Nursing Care Agency
  • Chicago, IL
  • NPI 1699664938
  NPD tax ID

Locations

All disclosed owners & managing parties 2

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

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324425600000",
    "number": "1538170345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 W TOUHY AVE",
            "address_2": "STE. 205-206",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606453198",
            "telephone_number": "773-274-7694",
            "fax_number": "773-274-9082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 W TOUHY AVE",
            "address_2": "STE. 205-206",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606453198",
            "telephone_number": "773-274-7694",
            "fax_number": "773-274-9082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT PARAGON HEALTH CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2011-12-21",
        "status": "A",
        "authorized_official_last_name": "OBASEKI",
        "authorized_official_first_name": "AIWUYO",
        "authorized_official_middle_name": "RITA",
        "authorized_official_title_or_position": "DIRECTOR/ADMINISTRATOR",
        "authorized_official_telephone_number": "773-274-7694",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1010583",
            "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 Dec 21, 2011; 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.