Provider Demographics
NPI:1053933184
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:PART OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAROOQ
Authorized Official - Middle Name:ANWAR
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-416-1013
Mailing Address - Street 1:980 PLAINFIRLAD ROAD
Mailing Address - Street 2:
Mailing Address - City:WILLOWBRROK
Mailing Address - State:IL
Mailing Address - Zip Code:60527
Mailing Address - Country:US
Mailing Address - Phone:630-547-6679
Mailing Address - Fax:
Practice Address - Street 1:980 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-1705
Practice Address - Country:US
Practice Address - Phone:630-541-6679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care