NPIMap

Organization Active NPI

Addus Healthcare, Inc.

Doing business as Addus Evergreen Club

  • In Home Supportive Care Agency
  • Alton, IL
National Provider Identifier
1740601236
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
ADDUS HEALTHCARE, INC.
Doing business as
Addus Evergreen Club
Practice address
88 Northport Dr
Alton, IL 62002-5940
Phone
(618) 433-9180
Fax
(618) 433-9182
NPI assigned
Dec 30, 2013
Last updated
Jun 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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

Authorized official

Name
Ms. Diane Kumarich, RN, MS, MBA
Title
National Contracts
Phone
(630) 296-3400

Specialties & licenses 1

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

Addresses

Primary practice location

88 Northport Dr
Alton, IL 62002-5940

Mailing address

2300 Warrenville Rd
Suite 100
Downers Grove, IL 60515-1765
Phone (630) 296-3400

Other names 1

  • Addus Evergreen Club Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Addus Healthcare Inc81 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

Locations

88 Northport Dr
Alton, IL 62002
Phone (618) 433-9180

NPI Registry JSON

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

{
    "created_epoch": "1388361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434499200000",
    "number": "1740601236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 WARRENVILLE RD",
            "address_2": "SUITE 100",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151765",
            "telephone_number": "630-296-3400",
            "fax_number": "630-487-2713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 NORTHPORT DR",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620025940",
            "telephone_number": "618-433-9180",
            "fax_number": "618-433-9182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDUS HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-30",
        "last_updated": "2015-06-17",
        "status": "A",
        "authorized_official_last_name": "KUMARICH",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "NATIONAL CONTRACTS",
        "authorized_official_telephone_number": "630-296-3400",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, MS, MBA"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Addus Evergreen Club",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; 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.