Graduated: 1987
Offers telehealth
NPI: 1225047921
Practice Locations (2)
PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC
2233 W DIVISION ST
CHICAGO, IL 606228151
3127702000
4009 W FULLERTON AVE
CHICAGO, IL 606392103
7736619049
Source: CMS National Downloadable File, September 2026.