Graduated: 1978
NPI: 1659406510
Practice Locations (4)
PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC
100 PROVENA WAY, SUITE 103
BOURBONNAIS, IL 609144797
8159378780
PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC
100 PROVENA WAY, SUITE C
BOURBONNAIS, IL 609144798
8159379370
PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC
100 N RIVER RD
DES PLAINES, IL 600161209
8472971800
PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC
500 W COURT ST
KANKAKEE, IL 609013661
8159372400
Source: CMS National Downloadable File, September 2026.