Provider Demographics
NPI:1376878231
Name:PRESTIGE PLUS HOME CARE, INC.
Entity Type:Organization
Organization Name:PRESTIGE PLUS HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TONGSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-635-7047
Mailing Address - Street 1:950 MILWAUKEE AVE
Mailing Address - Street 2:SUITE 236
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-3710
Mailing Address - Country:US
Mailing Address - Phone:847-635-7047
Mailing Address - Fax:
Practice Address - Street 1:950 MILWAUKEE AVE
Practice Address - Street 2:SUITE 236
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-3710
Practice Address - Country:US
Practice Address - Phone:847-635-7047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-11
Last Update Date:2009-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011153251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health