Provider Demographics
NPI:1235461765
Name:PRIMARY CARE SERVICES
Entity Type:Organization
Organization Name:PRIMARY CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:IRAM
Authorized Official - Middle Name:ALEEM
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-429-9000
Mailing Address - Street 1:2500 S HIGHLAND AVE
Mailing Address - Street 2:SUITE #: 230
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-5363
Mailing Address - Country:US
Mailing Address - Phone:630-429-9000
Mailing Address - Fax:630-429-9060
Practice Address - Street 1:2500 S HIGHLAND AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-5363
Practice Address - Country:US
Practice Address - Phone:630-429-9000
Practice Address - Fax:630-429-9060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-09
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036117593207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036117593Medicaid
ILIL3375Medicare PIN
ILDQ4287Medicare PIN
ILIL4905Medicare PIN