NPIMap

Organization Active NPI

Pro Active Health Services, Inc.

  • Home Health Agency
  • Skokie, IL
National Provider Identifier
1922397322
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PRO ACTIVE HEALTH SERVICES, INC.
Practice address
4350 Oakton Street
Suite 206
Skokie, IL 60076-3270
Phone
(773) 507-6464
NPI assigned
Apr 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Authorized official

Name
Ms. Shariffa Hanna F. Mohammad, B.S.N. R.N.
Title
Director of Nursing
Phone
(773) 507-6464

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

4350 Oakton Street
Suite 206
Skokie, IL 60076-3270

Mailing address

4350 Oakton St
Suite 206
Skokie, IL 60076-3270
Phone (773) 507-6464

Other identifiers 1

IdentifierTypeStateIssuer
163W00000XOtherILTAXONOMY CODE FOR NURSING

National Provider Directory

National Provider Directory

Locations

4350 Oakton St
Ste 206
Skokie, IL 60076
Phone (773) 507-6464

NPI Registry JSON

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1922397322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 OAKTON ST",
            "address_2": "SUITE 206",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600763270",
            "telephone_number": "773-507-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 OAKTON STREET",
            "address_2": "SUITE 206",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600763270",
            "telephone_number": "773-507-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO ACTIVE HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-06",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "MOHAMMAD",
        "authorized_official_first_name": "SHARIFFA HANNA",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "DIRECTOR OF NURSING",
        "authorized_official_telephone_number": "773-507-6464",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "B.S.N. R.N."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY CODE FOR NURSING",
            "identifier": "163W00000X",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.