Primehealth of Illinois Inc

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

PRIMEHEALTH OF ILLINOIS INC

Practice address

2100 E Lake Cook Rd
Suite 1000
Buffalo Grove, IL 60089-1999

Phone

(224) 632-5613

Fax

(844) 246-5875

NPI assigned

Jan 20, 2017

Last updated

Mar 21, 2017By 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

Kenneth King

Title

Owner

Phone

(844) 882-3127

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490054400000",
    "number": "1558808261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 E LAKE COOK RD",
            "address_2": "SUITE 1000",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891999",
            "telephone_number": "224-632-5613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 E LAKE COOK RD",
            "address_2": "SUITE 1000",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891999",
            "telephone_number": "224-632-5613",
            "fax_number": "844-246-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMEHEALTH OF ILLINOIS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-20",
        "last_updated": "2017-03-21",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "844-882-3127"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premier Eye Care & Surgery LTD
• Premier Foot & Ankle PC
• Elena Presta, OTR/L
• Michelle N Price, DPT
• Primehealth Group LLC
• Primehealth of Illinois LLC
• Primesource Healthcare Systems, Inc.
• Primesource Healthcare Systems, Inc.
• Primesource Healthcare Systems, Inc.
• Aeba T Prince, PT

• Podiatrist in Buffalo Grove, IL
• Providers in Buffalo Grove, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.