ICG HOME HEALTH (NPI# 1386094068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386094068 |
| Entity Type | Organization |
| Organization Name | ICG HOME HEALTH |
| Practice Address |
4508 Camden Ct Richton Park IL 60471-1147 |
| Practice Telephone | 7083691329 |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2016-06-14 |
| Authorized Official Name | TIFFANIE DIONNE JOHNSON (HOME HEALTH RN) |
| Authorized Official Telephone | 7083691329 |
| Authorized Official Credential | REGISTERED NURSE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 041379716 | IL | Nursing & Custodial Care Facilities |
| Street Address |
4508 CAMDEN CT |
| City | RICHTON PARK |
| State | IL |
| Zip Code | 60471-1147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386119501 | Welllife Behavioral Services, LLC | Social Worker | 4137 Sauk Trail, Suite 100, Richton Park, IL 60471 | 2018-10-04 |
| 1891149332 | Wal-mart Stores, Inc. | Technician/Technologist | 22401 Central Avenue, Richton Park, IL 60471 | 2016-04-21 |
| 1689049744 | Lauren Michelle Jackson | Counselor | 1046 Lioncrest Drive, Richton Park, IL 60471 | 2015-12-01 |
| 1326420092 | Denny's Health Care Services Inc | In Home Supportive Care | 4912 Arquilla Drive, Richton Park, IL 60471 | 2015-06-18 |
| 1538312475 | Illinois Behavioral Services Inc | Psychologist | 276 E 16th Street, Chicago Heights, IL 60471 | 2008-10-23 |
| 1588876601 | Getting To Know Me & My World | Home Health | 22006 Jordan Lane, Richton Park, IL 60471 | 2007-05-03 |
| 1982711990 | Camille Yolanda Humes | Counselor | 4511 Sauk Trail, Richton Park, IL 60471 | 2006-08-24 |
| 1003329657 | Elizabeth Eileen Mcelligott | Speech-Language Pathologist | 5000 Sauk Trl, Richton Park, IL 60471-1000 | 2017-11-06 |
| 1629083811 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 4889 Sauk Trl, Richton Park, IL 60471-1017 | 2006-07-29 |
| 1811267933 | Dwayne Kerry Hall | Pharmacist | 4889 Sauk Trl, Richton Park, IL 60471-1017 | 2012-01-05 |
| Find all providers in zip 60471 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871999078 | Midwest Health Operations LLC | Nursing Facility/Intermediate Care Facility | 3601 16th Ave, Sterling, IL 61081-4059 | 2014-11-15 |
| 1437410891 | Mado Healthcare | Nursing Facility/Intermediate Care Facility | 1541 North Wells, Chicago, IL 60610-1307 | 2012-06-01 |
| 1134405392 | Faith Community Health Services, Inc | Nursing Facility/Intermediate Care Facility | 4449 177th St, Country Club Hills, IL 60478-4705 | 2011-11-01 |
| 1215188487 | Petersen Health Care, Inc | Nursing Facility/Intermediate Care Facility | 144 Jounior Ave., Kewanee, IL 61443 | 2008-10-07 |
| 1699936054 | Pinckneyville Healthcare Center | Nursing Facility/Intermediate Care Facility | 708 Virginia Ct, Pinckneyville, IL 62274-1538 | 2008-06-18 |
| 1184894412 | Parents and Friends of The Slc-home 1 | Nursing Facility/Intermediate Care Facility | 3 Gundlach Pl, Swansea, IL 62226-4227 | 2008-03-03 |
| 1740463074 | St. Joseph's Home of Springfield | Nursing Facility/Intermediate Care Facility | 3306 S 6th Street Rd, Springfield, IL 62703-4735 | 2007-12-10 |
| 1821283573 | Royal Living Center Inc | Nursing Facility/Intermediate Care Facility | 200 South 9th Street, New Baden, IL 62265 | 2007-09-06 |
| 1235323841 | Parents and Friends of Slc | Nursing Facility/Intermediate Care Facility | 1450 Caseyville Ave, Swansea, IL 62226-4517 | 2007-08-28 |
| 1629276225 | Elizabeth Nursing Home Corp | Nursing Facility/Intermediate Care Facility | 540 Pleasant St, Elizabeth, IL 61028-9508 | 2007-07-05 |
| Find all providers with the same taxonomy | ||||
| City | RICHTON PARK |
| Zip Code | 60471 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.