EVERGREEN HOME CARE LTD (NPI# 1750496667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750496667 |
| Entity Type | Organization |
| Organization Name | EVERGREEN HOME CARE LTD |
| Practice Address |
6041 Dempster St Morton Grove IL 60053 |
| Mailing Address |
6041 Dempster St Morton Grove IL 60053-2943 |
| Practice Telephone | 8474709280 |
| Practice Fax Number | 8474709282 |
| Mailing Telephone | 8474709280 |
| Mailing Fax Number | 8474709928 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2020-09-30 |
| NPI Deactivation Date | 11/30/2018 |
| NPI Reactivation Date | 2018-12-08 |
| Authorized Official Name | GLORIA S KIM (PRESIDENT) |
| Authorized Official Telephone | 8474709280 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 253Z00000X | In Home Supportive Care | IL | Agencies | |
| Y | 251E00000X | Home Health | 1010796 | IL | Agencies |
| Street Address |
6041 DEMPSTER ST |
| City | MORTON GROVE |
| State | IL |
| Zip Code | 60053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457904344 | Inswan Health Care Ltd | Home Health | 6041 Dempster St, Morton Grove, IL 60053-2943 | 2019-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710536206 | 360 Rehabilitation & Physical Therapy LLC | Clinic/Center | 9041 Moody Avenue, Morton Grove, IL 60053 | 2019-09-06 |
| 1205312147 | Ziing Healthcare, Inc | Nursing Care | 6126 Lincoln Ave, Suite 1010, Morton Grove, IL 60053 | 2018-07-13 |
| 1578053674 | Megan Ruffalo | Home Health | 8922 Marion Ave, Morton Grove, IL 60053 | 2018-05-14 |
| 1215441381 | Kristen Marie Kowalski | Occupational Therapist | 8145 River Dr Ste 101, Morton Grove, IL 60053 | 2017-11-27 |
| 1760846190 | Lukasz Jarosinski | Physical Therapy Assistant | 8425 N Waukegan, Morton Grove, IL 60053 | 2016-04-12 |
| 1538547898 | Alysha Gillani | Behavioral Analyst | 9240 Merrill Ave, Morton Grove, IL 60053 | 2015-05-07 |
| 1043578909 | Jordan Jon Wolf | Social Worker | 9224 Cameron Lane, Morton Grove, IL 60053 | 2012-04-30 |
| 1427217454 | Amy Sakoda | Specialist | 9400 N Orile, Morton Grove, IL 60053 | 2008-06-05 |
| 1063679348 | Minsook Do Kroon | Chiropractor | 6021 W Dempster, Morton Grove, IL 60053 | 2008-05-22 |
| 1023282217 | Simona Balan | Dentist | 6223 W Dempster St, Morton Grove, IL 60053 | 2008-04-17 |
| Find all providers in zip 60053 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821611021 | Geoffrey A Hanson | Home Health | 7620 Dempster St, Morton Grove, IL 60053-1823 | 2020-05-21 |
| 1578053674 | Megan Ruffalo | Home Health | 8922 Marion Ave, Morton Grove, IL 60053 | 2018-05-14 |
| 1689029779 | Pentacare Therapy Services | Home Health | 8921 National Ave, Morton Grove, IL 60053-2028 | 2016-04-26 |
| 1790059590 | Holman Therapy, Inc. | Home Health | 5908 Capri Ln, Morton Grove, IL 60053-1522 | 2012-02-27 |
| 1437392008 | Aspire Home Health Care LLC | Home Health | 8930 Waukegan Rd Ste 200, Morton Grove, IL 60053-2116 | 2009-04-13 |
| 1790935229 | Mrc, LLC | Home Health | 6429 Dempster St, Morton Grove, IL 60053-2604 | 2008-09-20 |
| 1245363019 | Access Home Health Care Inc | Home Health | 8700 Waukegan Rd, Suite 214, Morton Grove, IL 60053-2103 | 2007-03-13 |
| 1881792075 | National Home Health Services, LLC | Home Health | 5811 Dempster St, Morton Grove, IL 60053-3017 | 2006-09-20 |
| 1306800537 | Central Preferred Home Health Services, Inc. | Home Health | 9030 Austin Ave, Morton Grove, IL 60053-2406 | 2006-04-14 |
| 1467443358 | Mch of Illinois, Inc. | Home Health | 8145 River Dr, Morton Grove, IL 60053-2645 | 2005-10-31 |
| Find all providers in MORTON GROVE | ||||
| City | MORTON GROVE |
| Zip Code | 60053 |
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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.