Prudential Home Health Services Corporation

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

PRUDENTIAL HOME HEALTH SERVICES CORPORATION

Practice address

4440 Lincoln Hwy Ste 205
Matteson, IL 60443-3803

Phone

(708) 709-0709

Fax

(708) 709-0220

NPI assigned

Aug 9, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Eme Udoetuk

Title

Administrator

Phone

(708) 709-0709

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Home health agency certification: CCN 147922

Legal name

PRUDENTIAL HOME HEALTH SERVICES CORPORATION

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Feb 20, 2007

Last certification

Jan 3, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Nov 23, 2004 in IL

Enrollment address

4440 Lincoln Hwy
Ste 205
Matteson, IL 60443-3803

Listed as

Prudential Home Health CorporationCCN 147922

Overall star rating

3 of 5

Ownership

Proprietary

Certified

Feb 20, 2007

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Janita Simpkins, M.D.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1760507651

  Home health agency

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1508876541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 LINCOLN HWY STE 205",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433803",
            "telephone_number": "708-709-0709",
            "fax_number": "708-709-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 LINCOLN HWY STE 205",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433803",
            "telephone_number": "708-709-0709",
            "fax_number": "708-709-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUDENTIAL HOME HEALTH SERVICES CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "UDOETUK",
        "authorized_official_first_name": "EME",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "708-709-0709",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1525293",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nursing Care Agency in Matteson, IL
• Providers in Matteson, IL by specialty
• Nursing Care Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.