Graduated: 1988
NPI: 1669473062
Practice Locations (2)
PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC
7435 W TALCOTT AVE
CHICAGO, IL 606313707
7737748000
PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC
100 N RIVER RD
DES PLAINES, IL 600161209
8472971800
Source: CMS National Downloadable File, September 2026.