Provider Demographics
NPI:1346953767
Name:PRIMARY HEALTH CARE LLC
Entity type:Organization
Organization Name:PRIMARY HEALTH CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAROOK
Authorized Official - Middle Name:A
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-416-1013
Mailing Address - Street 1:907 N ELM ST STE 101
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3644
Mailing Address - Country:US
Mailing Address - Phone:773-416-1013
Mailing Address - Fax:
Practice Address - Street 1:1355 E OGDEN AVE
Practice Address - Street 2:STE 109
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563
Practice Address - Country:US
Practice Address - Phone:630-555-1212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRIMARY HEALTH CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-30
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care