Graduated: 2011
NPI: 1194070458
Practice Locations (3)
PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC
100 PROVENA WAY, SUITE 103
BOURBONNAIS, IL 609144797
8159378780
PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC
21 HERITAGE DR, SUITE 102
BOURBONNAIS, IL 609141465
8159378204
PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC
500 W COURT ST
KANKAKEE, IL 609013661
8159372400
Source: CMS National Downloadable File, September 2026.