Organization
PRESTIGE PLUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. OLUWAKEMI IYABODE SULAIMON PCT (CEO)
(224) 717-0183
Entity
Organization
Contact information
Practice address
2714 HEBRON AVE, C, ZION, IL 60099-2487
(224) 717-0183
Mailing address
2714 HEBRON AVE, C, ZION, IL 60099-2487
(224) 717-0183
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
05/12/2013
Last updated
05/13/2013
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