NPIMap

Organization Active NPI

Community Care Systems, Inc.

  • In Home Supportive Care Agency
  • Homewood, IL
National Provider Identifier
1609287077
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
COMMUNITY CARE SYSTEMS, INC.
Practice address
17475 Jovanna Dr
Unit 2a
Homewood, IL 60430-1020
Phone
(708) 798-5996
Fax
(708) 798-7066
NPI assigned
May 19, 2014
Last updated
Oct 31, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Authorized official

Name
Mr. Frank J Vala
Title
Ceo
Phone
(217) 698-0200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X NU Primary

Addresses

Primary practice location

17475 Jovanna Dr
Unit 2a
Homewood, IL 60430-1020

Mailing address

405 N Macarthur Blvd
Springfield, IL 62702-2312
Phone (217) 698-0200

Other identifiers 1

IdentifierTypeStateIssuer
983MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Community Care Systems Inc14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

17475 Jovanna Dr
Ste 2A
Homewood, IL 60430
Phone (708) 798-5996

NPI Registry JSON

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477872000000",
    "number": "1609287077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N MACARTHUR BLVD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627022312",
            "telephone_number": "217-698-0200",
            "fax_number": "217-698-9862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17475 JOVANNA DR",
            "address_2": "UNIT 2A",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301020",
            "telephone_number": "708-798-5996",
            "fax_number": "708-798-7066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-19",
        "last_updated": "2016-10-31",
        "status": "A",
        "authorized_official_last_name": "VALA",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-698-0200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "983",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; 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.