Active NPI
Platinum Home Health Care, Inc.
- Home Health Agency
- Orland Park, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- IL10104096
- Legal business name
- PLATINUM HOME HEALTH CARE, INC.
- Practice address
- 16634 107TH St
Orland Park, IL 60467-8898 - Phone
- (708) 995-7758
- Fax
- (708) 995-7986
- NPI assigned
- Jun 19, 2006
- Last updated
- Nov 6, 2013
- 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
- Mr. Estelito Espano Jr.
- Title
- President
- Phone
- (708) 995-7758
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | IL10104096 | IL | Primary |
Addresses
Primary practice location
16634 107TH St
Orland Park, IL 60467-8898
Mailing address
16634 107TH St
Orland Park, IL 60467-8898
Phone (708) 995-7758
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IL1010409 | Other | IL | ILLINOIS LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050926001209 | IL | Part A Provider - Home Health Agency | 7214961424 | Practice locations: Orland Park, IL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1871538066. Details of each certification follow.
Home health agency certification: CCN 147864
- Legal name
- PLATINUM HOME HEALTH CARE, INC.
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Apr 11, 2006
- Last certification
- Mar 13, 2020
- Ownership / control type
- Proprietary
- Organization structure
- Other
- Incorporated
- Aug 17, 2004 in IL
- Enrollment address
- 16634 107TH St
Orland Park, IL 60467-8898
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Platinum Home Health Care, Inc
- Overall star rating
- Ownership
- Proprietary
- Certified
- Apr 11, 2006
- 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 |
|---|---|---|---|
| 14D1041697 | Platinum Home Health Care Inc | Certificate of waiver | Jun 8, 2027 |
National Provider Directory
National Provider DirectoryLocations
4903 W 95th St
Oak Lawn, IL 60453
Phone (708) 229-9338
16634 107th St
Orland Park, IL 60467
Phone (708) 995-7758
Ownership & related parties
All disclosed owners & managing parties 3
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 |
|---|---|---|---|
| Estelito Espano | 5% Or Greater Direct Ownership Interest | Aug 4, 2004 | 50% |
| Corporate Officer | Aug 4, 2004 | 50% | |
| Corporate Director | Aug 4, 2004 | 50% | |
| W-2 Managing Employee | Aug 4, 2004 | 50% | |
| Operational/Managerial Control | Aug 4, 2004 | 50% | |
| Marsha Espano | 5% Or Greater Direct Ownership Interest | Aug 4, 2004 | 10% |
| Corporate Officer | Aug 4, 2004 | 10% | |
| Corporate Director | Aug 4, 2004 | 10% | |
| W-2 Managing Employee | Aug 5, 2004 | 10% | |
| Operational/Managerial Control | Aug 4, 2004 | 10% | |
| Vilma Cristobal-Mendoza | 5% Or Greater Direct Ownership Interest | Aug 4, 2004 | 40% |
| Corporate Officer | Aug 4, 2004 | 40% | |
| Corporate Director | Aug 4, 2004 | 40% | |
| W-2 Managing Employee | Aug 4, 2004 | 40% | |
| Operational/Managerial Control | Aug 4, 2004 | 40% |
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": "1150675200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1383696000000",
"number": "1871538066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16634 107TH ST",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604678898",
"telephone_number": "708-995-7758",
"fax_number": "708-995-7986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16634 107TH ST",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604678898",
"telephone_number": "708-995-7758",
"fax_number": "708-995-7986"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PLATINUM HOME HEALTH CARE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-19",
"last_updated": "2013-11-06",
"status": "A",
"authorized_official_last_name": "ESPANO",
"authorized_official_first_name": "ESTELITO",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "708-995-7758",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "IL",
"license": "IL10104096",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILLINOIS LICENSE",
"identifier": "IL1010409",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Orland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; 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.