Healthcare Provider Details

I. General information

NPI: 1013838341
Provider Name (Legal Business Name): PRIME US MADICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 W 22ND ST
OAK BROOK IL
60523-2074
US

IV. Provider business mailing address

1415 W 22ND ST
OAK BROOK IL
60523-2074
US

V. Phone/Fax

Practice location:
  • Phone: 832-829-4971
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MUMTAZ YAHYA TUKDI
Title or Position: PRESIDENT
Credential:
Phone: 832-829-4971