Organization Active NPI

Prime Medical Associates LTD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1306052675
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
042618262 Issued in IL
Legal business name
PRIME MEDICAL ASSOCIATES LTD
Practice address
3414 W Peterson
Suite a
Chicago, IL 60659
Phone
(773) 478-1777
Fax
(773) 478-1964
NPI assigned
May 15, 2007
Last updated
Jul 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Authorized official

Name
Jong L Jin, MDNPI 1225062912
Title
President
Phone
(773) 478-1777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 042618262 IL Primary

Addresses

Primary practice location

3414 W Peterson
Suite a
Chicago, IL 60659

Mailing address

3414 W Peterson
Suite a
Chicago, IL 60659
Phone (773) 478-1777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040326001010 IL Part B Supplier - Clinic/Group Practice 3274425921 Receives reassigned benefits from 2 practitioners
Practice locations: Chicago, IL; Evanston, IL; Niles, IL; Skokie, IL

National Provider Directory

National Provider Directory

Locations

3414 W Peterson Ave
Ste A
Chicago, IL 60659
Phone (312) 478-1777

66 W Oak St
Chicago, IL 60610
Phone (312) 337-5400

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752451200000",
    "number": "1306052675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 W PETERSON",
            "address_2": "SUITE A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60659",
            "telephone_number": "773-478-1777",
            "fax_number": "773-478-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 W PETERSON",
            "address_2": "SUITE A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60659",
            "telephone_number": "773-478-1777",
            "fax_number": "773-478-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME MEDICAL ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A",
        "authorized_official_last_name": "JIN",
        "authorized_official_first_name": "JONG",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-478-1777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "042618262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.