Graduated: 2019
NPI: 1902403298
Practice Locations (3)
PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC
100 PROVENA WAY, SUITE 103
BOURBONNAIS, IL 609144797
8159378780
PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC
455 W COURT ST
KANKAKEE, IL 609013695
PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC
500 W COURT ST
KANKAKEE, IL 609013661
8159372400
Source: CMS National Downloadable File, September 2026.