MJM Health Agency, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1765224 Issued in IL

Legal business name

MJM HEALTH AGENCY, INC.

Practice address

5517 South Michigan Street
Lower Level
Chicago, IL 60615

Phone

(773) 643-0227

Fax

(773) 643-0227

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Kemi Assisat Andu-Alausa, CPA, MBA

Title

President

Phone

(630) 670-6416

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Home health agency certification: CCN 147956

Legal name

MJM HEALTH AGENCY, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

May 2, 2007

Last certification

Oct 18, 2018

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Oct 7, 2005 in IL

Enrollment address

1S311 Summit Ave
Oakbrook Terrace, IL 60181-3906

Listed as

MJM Health Agency, IncCCN 147956

Ownership

Proprietary

Certified

May 2, 2007

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

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.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vijay K Goyal, M.D.

  • Hematology & Oncology Physician
  • Rockford, IL
  • NPI 1407966484
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609954668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12807 FALCON CT",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604397300",
            "telephone_number": "773-643-0227",
            "fax_number": "773-643-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5517 SOUTH MICHIGAN STREET",
            "address_2": "LOWER LEVEL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60615",
            "telephone_number": "773-643-0227",
            "fax_number": "773-643-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJM HEALTH AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDU-ALAUSA",
        "authorized_official_first_name": "KEMI",
        "authorized_official_middle_name": "ASSISAT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-670-6416",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPA, MBA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1765224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1765224",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jezmine Mizyed, FNP
• MJ Medical Group SC
• Jeffrey M Mjaanes, MD
• Mjknight Enterprise LLC
• MJL Aesthetics, S.C.
• MJM Transportation
• MJPT 2 LLC
• MJT Podiatry SC
• MK Chiropractic
• MK Counseling and Wellness, PLLC

• 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 Aug 22, 2020; 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.