Primary Care of Illinois, SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PRIMARY CARE OF ILLINOIS, SC

Practice address

1550 N Northwest Hwy
Suite 211
Park Ridge, IL 60068-1411

Phone

(847) 768-9300

Fax

(847) 768-9393

NPI assigned

Feb 17, 2010

Last updated

Jul 7, 2015By 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

Dr. Eric J Pales, M.D.NPI 1508938507

Title

President/Owner

Phone

(847) 768-9300

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 2

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.

• Eric Jason Pales, M.D.

  • Internal Medicine Physician
  • Park Ridge, IL
  • NPI 1508938507
  Medicare reassignment NPD Authorized official
• Kara Ann Vormittag, M.D.

  • Family Medicine Physician
  • Skokie, IL
  • NPI 1497901292
  NPD

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436227200000",
    "number": "1114249125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 N NORTHWEST HWY",
            "address_2": "SUITE 211",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681411",
            "telephone_number": "847-768-9300",
            "fax_number": "847-768-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 N NORTHWEST HWY",
            "address_2": "SUITE 211",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681411",
            "telephone_number": "847-768-9300",
            "fax_number": "847-768-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE OF ILLINOIS, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-17",
        "last_updated": "2015-07-07",
        "status": "A",
        "authorized_official_last_name": "PALES",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "847-768-9300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prime Medical Equipment LLC
• Laura Prince, M.D.

• Internal Medicine Physician in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.