Graduated: 1993
NPI: 1699797548
Practice Locations (4)
PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC
100 PROVENA WAY, SUITE 103
BOURBONNAIS, IL 609144797
8159378780
PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC
656 N CONVENT ST
BOURBONNAIS, IL 609141393
PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC
100 N RIVER RD
DES PLAINES, IL 600161209
8472971800
PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC
555 W COURT ST, SUITE 406
KANKAKEE, IL 609013675
8159327474
Source: CMS National Downloadable File, September 2026.