Prime Health Care, LTD

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

PRIME HEALTH CARE, LTD

Practice address

333 East Il Route 83
Suite 105
Mundelein, IL 60060

Phone

(847) 970-9922

Fax

(847) 970-9955

NPI assigned

Aug 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mikhail Khodarkovskiy, M.D.

Title

Physician

Phone

(847) 970-9922

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187049600000",
    "number": "1922290980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 EAST IL ROUTE 83",
            "address_2": "SUITE 105",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "60060",
            "telephone_number": "847-970-9922",
            "fax_number": "847-970-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 EAST IL ROUTE 83",
            "address_2": "SUITE 105",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "60060",
            "telephone_number": "847-970-9922",
            "fax_number": "847-970-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTH CARE, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2007-08-14",
        "status": "A",
        "authorized_official_last_name": "KHODARKOVSKIY",
        "authorized_official_first_name": "MIKHAIL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "847-970-9922",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas W Pogue
• Timothy Joseph Poland, MD
• Mariana Polistchuk, M.S. CCC-SLP
• Thomas C Pomierski
• Marianna Poplavsky, PHARMD
• Provida Medical Supply, Inc.
• Katelyn Punches, RDN, LDN
• R & R Medical Supply, Inc. (Fair Haven Medical Supply)
• Aaron Raestas, DPM
• Jennifer S. Ramos, DC

• Health Service Clinic/Center in Mundelein, IL
• Providers in Mundelein, IL by specialty
• Health Service Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; 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.