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General NPI Number Information
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NPI Number | 1942255583
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Entity Type | Organization
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Legal Business Name | PRESTIGE HOME HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 03/21/2012
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Provider Practice Location Address
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Address Line | 8618 W CATALPA AVE SUITE 1115
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City | CHICAGO
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State | IL
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Zip | 60656-1705
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Country | US
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Telephone | 773-693-0100
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Fax | 773-693-0110
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Provider Business Mailing Address
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Address Line | 8618 W CATALPA AVE SUITE 1115
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City | CHICAGO
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State | IL
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Zip | 60656-1705
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Country | US
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Telephone | 773-693-0100
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Fax | 773-693-0110
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. JERRY HART
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Credential |
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Telephone | 773-693-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1010242
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License Number State | IL
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