MEDICARE: PRIMECARE MEDICAL ASSOCIATES, INC

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	207Q00000X	Family Medicine Physician		IL

General Provider Information

NPI Number	:	1659508356
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMECARE MEDICAL ASSOCIATES, INC

Provider Business Mailing Address
First Line	:	1375 E SCHAUMBURG RD
Second Line	:	SUITE 100
City	:	SCHAUMBURG
State	:	IL
Zip	:	60194-5166
Country	:	US
Telephone Number	:	847-891-6850
Fax Number	:	630-339-5803

Provider Business Practice Location Address
First Line	:	7114 S VINCENNES AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60621-3506
Country	:	US
Telephone Number	:	773-224-4800
Fax Number	:	847-890-6660

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. MIRZA BAIG
Credential	:
Telephone Number	:	773-224-4800

Provider Enumeration Date	:	06/19/2009
Last Update Date	:	07/17/2009

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