Active NPI
Providence Home Health Care, Inc
- Home Health Agency
- Northbrook, IL
National Provider Identifier
1851487854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 1010131
- Legal business name
- PROVIDENCE HOME HEALTH CARE, INC
- Practice address
- 425 Huehl Rd BLDG 20
Northbrook, IL 60062-2322 - Phone
- (847) 480-7877
- Fax
- (847) 714-0720
- NPI assigned
- Oct 5, 2006
- Last updated
- Dec 8, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Galina Safir
- Title
- Administrator
- Phone
- (847) 480-7877
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 1010131 | IL | Primary |
Addresses
Primary practice location
425 Huehl Rd BLDG 20
Northbrook, IL 60062-2322
Mailing address
425 Huehl Rd BLDG 20
Northbrook, IL 60062-2322
Phone (847) 480-7877
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040602001089 | IL | Part A Provider - Home Health Agency | 0547242786 | Practice locations: Northbrook, IL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1851487854. Details of each certification follow.
Home health agency certification: CCN 147710
- Legal name
- PROVIDENCE HOME HEALTH CARE, INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Mar 27, 2001
- Last certification
- Apr 15, 2021
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Mar 27, 2001 in IL
- Enrollment address
- 425 Huehl Road
BLDG 20
Northbrook, IL 60062-2322
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Providence Home Health Care, I
- Overall star rating
- Ownership
- Proprietary
- Certified
- Mar 27, 2001
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D0978075 | Providence Home Health Care Inc | Certificate of waiver | Sep 13, 2026 |
National Provider Directory
National Provider DirectoryLocations
425 Huehl Rd
Bldg 20
Northbrook, IL 60062
Phone (847) 480-7877
Ownership & related parties
All disclosed owners & managing parties 1
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Galina Safir | 5% Or Greater Direct Ownership Interest | Aug 15, 2018 | 100% |
| Corporate Officer | Dec 27, 2001 | ||
| W-2 Managing Employee | Dec 27, 2001 |
Practitioners & affiliated clinicians
Affiliated clinicians 9
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Nurse Practitioner
- North Riverside, IL
- NPI 1710503735
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1638921600000",
"number": "1851487854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 HUEHL RD BLDG 20",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600622322",
"telephone_number": "847-480-7877",
"fax_number": "847-714-0720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 HUEHL RD BLDG 20",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600622322",
"telephone_number": "847-480-7877",
"fax_number": "847-714-0720"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROVIDENCE HOME HEALTH CARE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-05",
"last_updated": "2021-12-08",
"certification_date": "2021-12-08",
"status": "A",
"authorized_official_last_name": "SAFIR",
"authorized_official_first_name": "GALINA",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "847-480-7877",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "IL",
"license": "1010131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.