Prime Health System ,Inc

Primary specialty

Integrative Medicine PhysicianTaxonomy code 202D00000X

Legal business name

PRIME HEALTH SYSTEM ,INC

Practice address

1030 N Clark St Ste 647
Chicago, IL 60610-5469

Phone

(847) 810-9095

NPI assigned

May 2, 2022

Organization subpart

No

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

Authorized official

Name

Liela Maatouk

Title

Administrator

Phone

(847) 730-7098

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651449600000",
    "number": "1861137135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 N CLARK ST STE 647",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606105469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 N CLARK ST STE 647",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606105469",
            "telephone_number": "847-810-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTH SYSTEM ,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-02",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A",
        "authorized_official_last_name": "MAATOUK",
        "authorized_official_first_name": "LIELA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "847-730-7098"
    },
    "taxonomies": [
        {
            "code": "202D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Integrative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "036086819",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Nextgen",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "address_1": "1030 N Clark St Ste 647",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606105469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jason C Primavera, D.D.S.
• Yevgeniya Primazova
• Ditte Primdahl, MD
• Prime Care Medical and Physical Therapy Centers, S.C.
• Prime Choice Medical Supplies, Inc.
• Prime Home Healthcare Services Corporation
• Prime Home Healthcare Services, LLC
• Prime Home Healthcare Services, LLC
• Prime Medical Associates LTD
• Prime Medical Center LTD

• Integrative Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Integrative Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.