Active NPI
Lincoln Home Health Care Inc.
- Home Health Agency
- Lincolnwood, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 1925211
- Legal business name
- LINCOLN HOME HEALTH CARE INC.
- Practice address
- 7301 N Lincoln Ave
Suite 121
Lincolnwood, IL 60712-1709 - Phone
- (847) 674-2342
- Fax
- (847) 673-0478
- NPI assigned
- Aug 5, 2009
- Last updated
- Aug 5, 2009
- 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
- Eliseo Favor Sotelo, ACCOUNTANT
- Title
- President
- Phone
- (773) 603-3441
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 1925211 | IL | Primary |
Addresses
Primary practice location
7301 N Lincoln Ave
Suite 121
Lincolnwood, IL 60712-1709
Mailing address
7301 N Lincoln Ave
Suite 121
Lincolnwood, IL 60712-1709
Phone (847) 674-2342
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091117000047 | IL | Part A Provider - Home Health Agency | 6800934605 | Practice locations: Rosemont, IL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1952532178. Details of each certification follow.
Home health agency certification: CCN 148189
- Legal name
- LINCOLN HOME HEALTH CARE INC.
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Sep 16, 2010
- Last certification
- Jan 17, 2020
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Enrollment address
- 10700 W Higgins Rd
Ste 250
Rosemont, IL 60018-3711
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Lincoln Home Health Care, Inc
- Overall star rating
- Ownership
- Proprietary
- Certified
- Sep 16, 2010
- 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 |
|---|---|---|---|
| 14D1055648 | Lincoln Home Health Care Inc | Certificate of waiver | Jun 21, 2028 |
National Provider Directory
National Provider DirectoryLocations
4001 W Devon Ave
Ste 510
Chicago, IL 60646
Phone (847) 674-2342
10700 W Higgins Rd
Ste 250
Rosemont, IL 60018
Phone (847) 674-2342
5142 Main St
Ste 100
Skokie, IL 60077
Phone (847) 674-2342
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 |
|---|---|---|---|
| Vertex Holdinds LLC | 5% Or Greater Direct Ownership Interest | Mar 18, 2019 | 100% |
| Operational/Managerial Control | Mar 18, 2019 | ||
| Franics Bautista | 5% Or Greater Indirect Ownership Interest | Feb 19, 2020 | 50% |
| Corporate Officer | Mar 18, 2019 | 50% | |
| Corporate Director | Mar 18, 2019 | 50% | |
| W-2 Managing Employee | Mar 18, 2019 | 50% | |
| Operational/Managerial Control | Mar 18, 2019 | 50% | |
| Darius Corpuz | 5% Or Greater Indirect Ownership Interest | Feb 19, 2020 | 50% |
| Corporate Officer | Feb 19, 2020 | 50% | |
| Corporate Director | Feb 19, 2020 | 50% | |
| Operational/Managerial Control | Feb 19, 2020 | 50% |
Practitioners & affiliated clinicians
Affiliated clinicians 6
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Naperville, IL
- NPI 1720006919
Home health agency
-
- Family Nurse Practitioner
- Arlington Heights, IL
- NPI 1679933311
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249430400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1249430400000",
"number": "1952532178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7301 N LINCOLN AVE",
"address_2": "SUITE 121",
"city": "LINCOLNWOOD",
"state": "IL",
"postal_code": "607121709",
"telephone_number": "847-674-2342",
"fax_number": "847-673-0478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7301 N LINCOLN AVE",
"address_2": "SUITE 121",
"city": "LINCOLNWOOD",
"state": "IL",
"postal_code": "607121709",
"telephone_number": "847-674-2342",
"fax_number": "847-673-0478"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LINCOLN HOME HEALTH CARE INC.",
"organizational_subpart": "NO",
"enumeration_date": "2009-08-05",
"last_updated": "2009-08-05",
"status": "A",
"authorized_official_last_name": "SOTELO",
"authorized_official_first_name": "ELISEO",
"authorized_official_middle_name": "FAVOR",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "773-603-3441",
"authorized_official_credential": "ACCOUNTANT"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "IL",
"license": "1925211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lincolnwood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2009; 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.