Avesena Inc.
Organization Active NPI Home Health Agency · Addison, IL
NPI 1700964855 · NPPES record last updated Dec 10, 2008
Key facts
- NPI
- 1700964855
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- AVESENA INC.
- Practice address
- 221 E Lake St
Suite 108
Addison, IL 60101-2888 - Phone
- (630) 833-2486
- Fax
- (630) 833-2487
- NPI assigned
- Nov 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Mohammad Aslam, MBA
- Title
- Administrator
- Phone
- (630) 833-2486
Affiliated clinicians 7
-
Nausheen Hasan, M.D.
-
Mandeep S Kohli, D.O
-
Maninder S. Kohli, M.D.
-
Bilquis Mohammed, FNP
-
Kalpana Mutyala, APN
-
Kathleen A Ward, M.D.
-
Marc L Wiener, M.D.
Medicare Care Compare: Home health agency
- Listed as
- Avesena Home Health Care
- Overall star rating
- ★★★☆☆ 3 of 5
- Ownership
- Proprietary
- Certified
- Apr 1, 2005
- 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 |
|---|---|---|---|
| 14D1024599 | Avesena Home Health Care | Certificate of waiver | Apr 14, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Home health agency certification: CCN 147802
- Legal name
- AVESENA INC.
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Apr 1, 2005
- Last certification
- Sep 25, 2020
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Incorporated
- Oct 27, 2003 in IL
- Enrollment address
- 221 E. Lake Street
Suite 108
Addison, IL 60101-2851
All disclosed owners & managing parties 1
| Name | Role | Since | Share |
|---|---|---|---|
| Mohammad Aslam |
5% Or Greater Direct Ownership Interest |
Aug 31, 2008 | 100% |
| W-2 Managing Employee |
Aug 31, 2008 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040806000999 | IL | Part a Provider - Home Health Agency | 4789656109 | Practice locations: Addison, IL |
National Provider Directory
Locations
221 E Lake St
Ste 108
Addison, IL 60101
Phone (630) 833-2486
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
221 E Lake St
Suite 108
Addison, IL 60101-2888
Mailing address
221 E Lake St
Suite 108
Addison, IL 60101-2888
Phone (630) 833-2486
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IL1010340 | Other | IL | STATE ID |
Other names
- Avesena Home Health Care
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All providers in Addison, 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 10, 2008. 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.