| Prima Medical Practices Inc | |
|
1875 Dempster St Ste 110 Park Ridge IL 60068-1125 | |
| (847) 897-9010 | |
| (847) 692-2129 |
| Full Name | Prima Medical Practices Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1875 Dempster St Ste 110, Park Ridge, Illinois |
| Authorized Official Name and Position | Larisa Lev (OWNER) |
| Authorized Official Contact | 8478979010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prima Medical Practices Inc 541 Helen Dr Northbrook IL 60062-2527 Ph: (847) 897-9010 | Prima Medical Practices Inc 1875 Dempster St Ste 110 Park Ridge IL 60068-1125 Ph: (847) 897-9010 |
| NPI Number | 1295332104 |
|---|---|
| Provider Enumeration Date | 10/04/2020 |
| Last Update Date | 12/28/2020 |
| Medicare PECOS PAC ID | 9032521604 |
|---|---|
| Medicare Enrollment ID | O20201224000244 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295332104 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Andrey Lev-weissberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245206655 PECOS PAC ID: 7810906864 Enrollment ID: I20060427000141 |
| Provider Name | Merchant Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891156444 PECOS PAC ID: 8628351871 Enrollment ID: I20170213002266 |
| Provider Name | Mary-jennelle Guevara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225397268 PECOS PAC ID: 4789931817 Enrollment ID: I20210104002202 |
| Provider Name | Michael Castaneda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114543055 PECOS PAC ID: 8527456599 Enrollment ID: I20211025000074 |
| Provider Name | Irina Kaushansky |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1306621883 PECOS PAC ID: 3779936604 Enrollment ID: I20240126003882 |
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