{
"Npi": {
"NPI": "1396938783",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "OPTIMUM HOME HEALTH CARE INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2720 S RIVER RD STE 202",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DES PLAINES",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60018-4111",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "708-422-7340",
"MailingAddressFaxNumber": "708-422-7348",
"FirstLinePracticeLocationAddress": "2720 S RIVER RD STE 202",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DES PLAINES",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60018-4111",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "708-422-7340",
"PracticeLocationAddressFaxNumber": "708-422-7348",
"EnumerationDate": "08/20/2007",
"LastUpdateDate": "03/05/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DE VERA",
"AuthorizedOfficialFirstName": "MARIA",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "708-422-7340",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "1010740",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}