Provider Demographics
NPI:1922278258
Name:PRESTIGE HOME HEALTHCARE INC.
Entity Type:Organization
Organization Name:PRESTIGE HOME HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:UJU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-392-2088
Mailing Address - Street 1:7667 W 95TH ST STE 306
Mailing Address - Street 2:
Mailing Address - City:HICKORY HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60457-2284
Mailing Address - Country:US
Mailing Address - Phone:708-233-9057
Mailing Address - Fax:708-233-9058
Practice Address - Street 1:7840 W 103RD ST
Practice Address - Street 2:SUITE #6
Practice Address - City:PALOS HILLS
Practice Address - State:IL
Practice Address - Zip Code:60465-1571
Practice Address - Country:US
Practice Address - Phone:708-233-9057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010829251E00000X
251E00000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1010829Medicaid
IL3001555Medicaid