Organization Active NPI

Lincoln Home Health Care Inc.

  • Home Health Agency
  • Lincolnwood, IL
National Provider Identifier
1952532178
Registry record updated Aug 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1925211 Issued in IL
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, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2009

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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
CorporationProprietary
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, IncCCN 148189 · All quality measures
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Sep 16, 2010
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D1055648Lincoln Home Health Care Inc10700 W Higgins - Ste 250, Rosemont, IL 60018Certificate of waiverJun 21, 2028

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
Vertex Holdinds LLC Organization, Des Plaines, IL LLC 5% Or Greater Direct Ownership Interest Mar 18, 2019 100%
Operational/Managerial Control Mar 18, 2019
Franics Bautista Individual 5% Or Greater Indirect Ownership InterestPresident Feb 19, 2020 50%
Corporate OfficerCorporate Secretary Mar 18, 2019 50%
Corporate DirectorCorporate President/Secretary Mar 18, 2019 50%
W-2 Managing EmployeeAd; Mar 18, 2019 50%
Operational/Managerial ControlPresident/Administrator Mar 18, 2019 50%
Darius Corpuz Individual 5% Or Greater Indirect Ownership InterestCfo Feb 19, 2020 50%
Corporate OfficerCfo/Board of Director Feb 19, 2020 50%
Corporate DirectorBoard of Directors Feb 19, 2020 50%
Operational/Managerial ControlCfo Feb 19, 2020 50%

Practitioners & affiliated clinicians

Affiliated clinicians 6

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": "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

Verify at the official NPI Registry.