Organization Active NPI

Prestige Home Health Services, Inc.

  • Home Health Agency
  • Chicago, IL
National Provider Identifier
1942255583
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1010242 Issued in IL
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

Updated by the provider on Mar 21, 2012

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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
CorporationProprietary
Enrollment address
7119 W Higgins Ave
Chicago, IL 60656-1903

Care Compare: Home health agency

Medicare Care Compare
Listed as
Prestige Home Health Services, IncCCN 147742 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Jul 30, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D1010198Prestige Home Health Services Inc7119 W Higgins Ave, Chicago, IL 60656Certificate of waiverMar 6, 2027

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
Jerry Pascual Hart Individual 5% Or Greater Direct Ownership Interest Jul 9, 2010 33.33%
Corporate Director Jul 9, 2010
W-2 Managing EmployeeAd; Dec 19, 2002
Leonida Shntiago Mandigma Individual 5% Or Greater Direct Ownership Interest Sep 25, 2002
W-2 Managing EmployeeDon Sep 25, 2002
Marilou Jacinto Valencia Individual 5% Or Greater Direct Ownership Interest Sep 25, 2002
General Partnership Interest Apr 23, 2003
W-2 Managing EmployeeAsst Don/Nursing Supervisor Sep 25, 2002
Theresa Almendrala Franco Individual 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.

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

Verify at the official NPI Registry.