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NPI Code Detail

MEDICARE: PRESTIGE HOME HEALTH SERVICES, INC.

MEDICARE: PRESTIGE HOME HEALTH SERVICES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency1010242IL

General Provider Information

NPI Number : 1942255583
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRESTIGE HOME HEALTH SERVICES, INC.
Provider Business Mailing Address
First Line : 8618 W CATALPA AVE
Second Line : SUITE 1115
City : CHICAGO
State : IL
Zip : 60656-1705
Country : US
Telephone Number : 773-693-0100
Fax Number : 773-693-0110
Provider Business Practice Location Address
First Line : 8618 W CATALPA AVE
Second Line : SUITE 1115
City : CHICAGO
State : IL
Zip : 60656-1705
Country : US
Telephone Number : 773-693-0100
Fax Number : 773-693-0110
Authorized Official
Title or Position : OFFICE MANAGER
Name : MR. JERRY HART
Credential :
Telephone Number : 773-693-0100
Provider Enumeration Date : 05/23/2006
Last Update Date : 03/21/2012

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