Prime Care Resource, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1006683 Issued in IL

Legal business name

PRIME CARE RESOURCE, INC.

Practice address

1420 Renaissance Dr Ste 410
Park Ridge, IL 60068-1345

Phone

(847) 827-4448

Fax

(847) 827-6448

NPI assigned

Feb 7, 2007

Organization subpart

No

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

Authorized official

Name

Corazon Monzon

Title

Administrator

Phone

(847) 827-4448

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Home health agency certification: CCN 147601

Legal name

PRIME CARE RESOURCE, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Dec 20, 1994

Last certification

Jan 8, 2021

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Mar 3, 1994 in IL

Enrollment address

9406 Waukegan Rd
Morton Grove, IL 60053-1352

Listed as

Prime Care Resource, IncCCN 147601

Overall star rating

3.5 of 5

Ownership

Proprietary

Certified

Dec 20, 1994

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Rumana Farheen Siddiqui, MD

  • Family Medicine Physician
  • Arlington Heights, IL
  • NPI 1770777377

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318896000000",
    "number": "1942340252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 RENAISSANCE DR STE 410",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681345",
            "fax_number": "847-827-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 RENAISSANCE DR STE 410",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681345",
            "telephone_number": "847-827-4448",
            "fax_number": "847-827-6448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME CARE RESOURCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2011-10-18",
        "status": "A",
        "authorized_official_last_name": "MONZON",
        "authorized_official_first_name": "CORAZON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "847-827-4448"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1006683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Prezas
• Elizabeth Price, DO
• Prima Medical Practices Inc
• Primary Care Center, S.C.
• Primary Care of Illinois, SC
• Prime Healthcare Senior Living, LLC
• Prime Home Health Services, Inc.
• Prime Medical Equipment LLC
• Laura Prince, M.D.
• Priority Anesthesia LLC

• Home Health Agency in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Home Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.