Active NPI
Prestige Home Health Services, Inc.
- Home Health Agency
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 1010242
- Legal business name
- PRESTIGE HOME HEALTH SERVICES, INC.
- Practice address
- 8618 W Catalpa Ave
Suite 1115
Chicago, IL 60656-1705 - Phone
- (773) 693-0100
- Fax
- (773) 693-0110
- NPI assigned
- May 23, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jerry Hart
- Title
- Office Manager
- Phone
- (773) 693-0100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 1010242 | IL | Primary |
Addresses
Primary practice location
8618 W Catalpa Ave
Suite 1115
Chicago, IL 60656-1705
Mailing address
8618 W Catalpa Ave
Suite 1115
Chicago, IL 60656-1705
Phone (773) 693-0100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030423000066 | IL | Part A Provider - Home Health Agency | 9133038979 | Practice locations: Chicago, IL |
Home health agency certification: CCN 147742
- Legal name
- PRESTIGE HOME HEALTH SERVICES, INC.
- Doing business as
- PRESTIGE HOME HEALTH SERVICES, INC.
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jul 30, 2003
- Last certification
- Feb 7, 2019
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Enrollment address
- 7119 W Higgins Ave
Chicago, IL 60656-1903
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Prestige Home Health Services, Inc
- Overall star rating
- Ownership
- Proprietary
- Certified
- Jul 30, 2003
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D1010198 | Prestige Home Health Services Inc | Certificate of waiver | Mar 6, 2027 |
National Provider Directory
National Provider DirectoryLocations
8618 W Catalpa Ave
Ste 1115
Chicago, IL 60656
Phone (773) 693-0100
7119 W Higgins Ave
Chicago, IL 60656
Phone (773) 693-0100
4363 N Harlem Ave
Rear
Norridge, IL 60706
Phone (708) 457-0100
Ownership & related parties
All disclosed owners & managing parties 4
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Jerry Pascual Hart | 5% Or Greater Direct Ownership Interest | Jul 9, 2010 | 33.33% |
| Corporate Director | Jul 9, 2010 | ||
| W-2 Managing Employee | Dec 19, 2002 | ||
| Leonida Shntiago Mandigma | 5% Or Greater Direct Ownership Interest | Sep 25, 2002 | |
| W-2 Managing Employee | Sep 25, 2002 | ||
| Marilou Jacinto Valencia | 5% Or Greater Direct Ownership Interest | Sep 25, 2002 | |
| General Partnership Interest | Apr 23, 2003 | ||
| W-2 Managing Employee | Sep 25, 2002 | ||
| Theresa Almendrala Franco | 5% Or Greater Direct Ownership Interest | Sep 25, 2002 | |
| General Partnership Interest | Apr 23, 2003 |
Practitioners & affiliated clinicians
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Nurse Practitioner
- River Forest, IL
- NPI 1912756131
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1332288000000",
"number": "1942255583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8618 W CATALPA AVE",
"address_2": "SUITE 1115",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606561705",
"telephone_number": "773-693-0100",
"fax_number": "773-693-0110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8618 W CATALPA AVE",
"address_2": "SUITE 1115",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606561705",
"telephone_number": "773-693-0100",
"fax_number": "773-693-0110"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRESTIGE HOME HEALTH SERVICES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-23",
"last_updated": "2012-03-21",
"status": "A",
"authorized_official_last_name": "HART",
"authorized_official_first_name": "JERRY",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "773-693-0100",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "IL",
"license": "1010242",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.