Provider Demographics
NPI:1811626500
Name:PRAIRIE HOME HEALTHCARE SERVICES CORPORATION
Entity type:Organization
Organization Name:PRAIRIE HOME HEALTHCARE SERVICES CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AGENCY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUSHEGUN
Authorized Official - Middle Name:VICTOR
Authorized Official - Last Name:OLAPOJOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-366-2227
Mailing Address - Street 1:399 PINE LAKE CIR
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1255
Mailing Address - Country:US
Mailing Address - Phone:847-291-7700
Mailing Address - Fax:847-242-2349
Practice Address - Street 1:399 PINE LAKE CIR
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1255
Practice Address - Country:US
Practice Address - Phone:847-291-7700
Practice Address - Fax:847-242-2349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2023-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care