PRIME HEALTH CARE, LTD


Address: 333 East Il Route 83, Suite 105, Mundelein, IL 60060
Phone: 8479709922

PRIME HEALTH CARE, LTD (NPI# 1922290980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1922290980
Entity Type Organization
Organization Name PRIME HEALTH CARE, LTD
Practice Address 333 East Il Route 83
Suite 105
Mundelein
IL 60060
Practice Telephone 8479709922
Practice Fax Number 8479709955
Mailing Telephone 8479709922
Mailing Fax Number 8479709955
Enumeration Date 2007-08-14
Last Update Date 2007-08-14
Authorized Official Name DR. MIKHAIL KHODARKOVSKIY (PHYSICIAN)
Authorized Official Telephone 8479709922
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QH0100X Clinic/Center
Specialization: Health Service
IL Ambulatory Health Care Facilities

Office Location

Street Address 333 EAST IL ROUTE 83
SUITE 105
City MUNDELEIN
State IL
Zip Code 60060

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Taxonomy Information

Taxonomy Code 261QH0100X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Health Service

Taxonomy Definition

Definition to come...
Notes: [7/1/2006: modified title]

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Competitor

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City MUNDELEIN
Zip Code 60060

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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