Kelly Home Healthcare, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

KELLY HOME HEALTHCARE, INC

Practice address

3235 Vollmer Rd Ste 107
Flossmoor, IL 60422-2069

Phone

(708) 983-9903

Fax

(708) 960-0419

NPI assigned

Jul 15, 2008

Organization subpart

No

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

Authorized official

Name

Nneka Ezurike-Green

Title

President

Phone

(708) 983-9903

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Angels Home Healthcare Services, Inc

  • Home Health Agency
  • Des Plaines, IL
  • NPI 1255064325

  Sold to, 2022-04-29

  CMS change of ownership

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284681600000",
    "number": "1790949154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3235 VOLLMER RD STE 107",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222069",
            "telephone_number": "708-983-9903",
            "fax_number": "708-960-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3235 VOLLMER RD STE 107",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222069",
            "telephone_number": "708-983-9903",
            "fax_number": "708-960-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY HOME HEALTHCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-15",
        "last_updated": "2010-09-17",
        "status": "A",
        "authorized_official_last_name": "EZURIKE-GREEN",
        "authorized_official_first_name": "NNEKA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-983-9903"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joliet Oncology Hematology Associates, LTD.
• Wanda Jones
• Alexis Jordan
• Judy Ann Johnson, DDS, PC
• Erin Keigher, CCC-SLP
• Naomi Kelly
• Ryan Kelly, LCSW
• Tiffany Kimble, CLC
• Bernadette King
• Lakeisha Kirby, LPC

• Home Health Agency in Flossmoor, IL
• Providers in Flossmoor, 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 Sep 17, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.