Prime Healthcare Agency LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

PRIME HEALTHCARE AGENCY LLC

Practice address

9221 S 79TH CT
Hickory Hills, IL 60457-2280

Phone

(708) 645-6166

NPI assigned

Apr 26, 2023

Organization subpart

No

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

Authorized official

Name

Zain Rehman, CRNA

Title

Managing Partner

Phone

(708) 645-6166

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707955200000",
    "number": "1891483061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9221 S 79TH CT",
            "city": "HICKORY HILLS",
            "state": "IL",
            "postal_code": "604572280",
            "telephone_number": "708-645-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9221 S 79TH CT",
            "city": "HICKORY HILLS",
            "state": "IL",
            "postal_code": "604572280",
            "telephone_number": "708-645-6166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 W Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606544844",
            "country_code": "US",
            "telephone_number": "312-222-5610",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1212 N La Salle Dr",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606108027",
            "country_code": "US",
            "telephone_number": "312-943-7246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIME HEALTHCARE AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-26",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "REHMAN",
        "authorized_official_first_name": "ZAIN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "708-645-6166",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Certified Registered Nurse Anesthetist in Hickory Hills, IL
• Providers in Hickory Hills, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.