NPIMap

Organization Active NPI

Greatland Home Health Services, Inc.

  • Home Health Agency
  • Naperville, IL
National Provider Identifier
1790776888
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
IL1010350 Issued in IL
Legal business name
GREATLAND HOME HEALTH SERVICES, INC.
Practice address
24W500 Maple Ave
Suite 205
Naperville, IL 60540-6055
Phone
(630) 548-2126
Fax
(630) 364-1506
NPI assigned
Oct 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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

Authorized official

Name
Mr. Monsuru Hassan
Title
Executive Director
Phone
(630) 548-2126

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X IL1010350 IL Primary

Addresses

Primary practice location

24W500 Maple Ave
Suite 205
Naperville, IL 60540-6055

Mailing address

PO Box 1010
Bolingbrook, IL 60440-0141
Phone (630) 548-2126

Other identifiers 3

IdentifierTypeStateIssuer
50432OtherILBLUE CROSS BLUE SHIELD
7717763OtherILAETNA
IL1010350OtherILSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050105000671 IL Part A Provider - Home Health Agency 9830147933 Practice locations: Naperville, IL
O20130626000029 IL Part B Supplier - Independent Clinical Laboratory 9830147933 Practice locations: Naperville, IL

Home health agency certification: CCN 147819

Legal name
GREATLAND HOME HEALTH SERVICES INC
Doing business as
GREATLAND STAFFING SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 8, 2005
Last certification
Nov 6, 2020
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Dec 16, 2003 in IL
Enrollment address
24W500 Maple Ave
Ste 205
Naperville, IL 60540-6057

Care Compare: Home health agency

Medicare Care Compare
Listed as
Greatland Home Health Services, IncCCN 147819
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Aug 8, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

1783 S Washington St
Ste 105B
Naperville, IL 60565
Phone (630) 548-2126

Ownership & related parties

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.

NameRoleSinceShare
Kehinde Hassan Individual 5% Or Greater Direct Ownership Interest Dec 16, 2003
Monsuru Hassan Individual 5% Or Greater Direct Ownership InterestPresident / Executive Director Dec 16, 2003 50%
W-2 Managing EmployeeExecutive Director Dec 16, 2003

Practitioners & affiliated clinicians

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420761600000",
    "number": "1790776888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1010",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604400141",
            "telephone_number": "630-548-2126",
            "fax_number": "630-364-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24W500 MAPLE AVE",
            "address_2": "SUITE 205",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406055",
            "telephone_number": "630-548-2126",
            "fax_number": "630-364-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATLAND HOME HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-29",
        "last_updated": "2015-01-09",
        "status": "A",
        "authorized_official_last_name": "HASSAN",
        "authorized_official_first_name": "MONSURU",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "630-548-2126",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "IL1010350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "50432",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7717763",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "IL1010350",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.