Prime Healthcare Illinois Medical Group LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC

Practice address

2380 E Dempster St
Des Plaines, IL 60016-4839

Phone

(833) 291-0464

NPI assigned

Oct 9, 2024

Last updated

Oct 9, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Christopher Doan

Title

Managing Associate General Counsel

Phone

(310) 259-4706

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Health Emergency Assistance of Detroit

  dba Corktown Health

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1285092767

  Member Of

  NPD member

Locations

Practitioners 433

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Suhair Abdel-Jalil, MD

  • Rheumatology Physician
  • Evanston, IL
  • NPI 1174572929

  Specialist

  Medicare reassignment Care Compare group NPD
• John Henry Affinito, MD

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1316930191
  Medicare reassignment Care Compare group NPD
• Azka Afzal

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1841645207
  Medicare reassignment Care Compare group NPD
• Rahul K. Agarwal, M.D.

  • Hospitalist Physician
  • Naperville, IL
  • NPI 1992930374

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Vasia A Ahmed, M.D.

  • Hematology & Oncology Physician
  • Tinley Park, IL
  • NPI 1992797047
  Medicare reassignment Care Compare group NPD
• Muhammad Sikander Akbar, M.D.

  • Interventional Cardiology Physician
  • Evanston, IL
  • NPI 1952513335

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Olayinka Akinyemi Akinola, M.D., MPH

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1043593049
  Medicare reassignment Care Compare group NPD
• Eyad Alhaj, MD

  • Interventional Cardiology Physician
  • Bourbonnais, IL
  • NPI 1770698375

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Syeda Ali, MD

  • Family Medicine Physician
  • Aurora, IL
  • NPI 1265732176
  Medicare reassignment Care Compare group NPD
• Adeeb Alshahrour, MD

  • Obstetrics & Gynecology Physician
  • Chicago, IL
  • NPI 1225047921
  Medicare reassignment Care Compare group NPD
• Rushdi Alul, DO

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1649365529
  Medicare reassignment Care Compare group NPD
• Ahmad Alwakkaf

  • Hospitalist Physician
  • Chicago, IL
  • NPI 1881031755

  Internal Medicine

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1023837689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 E DEMPSTER ST",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600164839",
            "telephone_number": "833-291-0464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2380 E DEMPSTER ST",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600164839",
            "telephone_number": "833-291-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGING ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "310-259-4706"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prime Physical Therapy
• Prime Tech Services Inc (Therapeutic Services of America)
• Prime Tech Services Inc (Therapeutic Services of America)
• Prince George Internal Medicine SC
• Principle Performance, Inc

• Multi-Specialty Clinic/Center in Des Plaines, IL
• Providers in Des Plaines, IL by specialty
• Multi-Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.