MEDICARE: PRIME CARE HEALTH MANAGEMENT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1164349320
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME CARE HEALTH MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	450 E HIGGINS RD STE 1000
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-1406
Country	:	US
Telephone Number	:	317-891-4501
Fax Number	:	312-395-7290

Provider Business Practice Location Address
First Line	:	450 E HIGGINS RD STE 1000
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-1406
Country	:	US
Telephone Number	:	317-891-4501
Fax Number	:	312-395-7290

Authorized Official
Title or Position	:	OWNER
Name	:	MAHMOOD MEEZAN MEHDI SYED
Credential	:
Telephone Number	:	317-891-4501

Provider Enumeration Date	:	06/30/2026
Last Update Date	:	06/30/2026

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