Organization
PRODIGY HOME CARE, INC,
Active
Other names
Entera Healthcare South
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA MARIE DIZON-ARROJO (ADMINISTRATOR)
(708) 444-4027
Entity
Organization
Contact information
Practice address
1010 JORIE BLVD STE 34, OAK BROOK, IL 60523-2215
(708) 444-4027
(708) 444-4713
Mailing address
1010 JORIE BLVD STE 34, OAK BROOK, IL 60523-2215
(708) 444-4027
(708) 444-4713
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
1011859
IL
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1011859
IDPH
IL
Enumeration date
05/25/2006
Last updated
02/28/2019
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