Providence at Home – Home Health Agency, NPI 1568461820

Providence at Home is a healthcare provider. based in Tinley park, Illinois. specializing in Home Health Agency. The organization holds a License No. 1010138 (IL). The NPI Number for Providence at Home is 1568461820

Main info

Organization
Name
Providence at Home
NPI
1568461820
Phone
(800) 509-2800
Address
18601 N CREEK DR
Authorized Official
JOHANNA ZANDSTRA VICE PRESIDENT OF OPERATIONS
Enumeration Date
19 July 2005
Last Update Date
1 October 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness90
Years active:20State licenses:1Digital endpoints

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Provider Addresses for Providence at Home

  • North Creek Drive, Tinley Park, Will County, Illinois, 60477, United States

    TINLEY PARK, IL 604776397

    Phone: (800) 509-2800

    Fax: (708) 877-4818

    Type: Mailing

  • 14301 INDEPENDENCE WAY

    HOMER GLEN, IL 604917210

    Phone: (800) 509-2800

    Fax: (708) 877-4818

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-09-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2026-01-31 (130 days ago).

Enrollment records

1

Earliest due date

2026-01-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20070904000298OHome Health AgencyIL2026-01-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60477)

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Reviews

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Frequently asked questions

Is there an official ID for Providence at Home in U.S. healthcare records?
The official identifier for Providence at Home is NPI 1568461820.
Active or inactive — what applies to Providence at Home?
You should see Providence at Home as active in CMS-hosted NPPES data.
What kind of doctor is Providence at Home?
Providence at Home is associated with Home Health Agency in the directory — Clinical services aligned with this taxonomy classification.
Where in Illinois is Providence at Home registered?
Use Tinley Park, Illinois as the headline location for Providence at Home here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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