Healthcare Provider Details

I. General information

NPI: 1568618783
Provider Name (Legal Business Name): PRIME HEALTH MEDICAL AND REHAB LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2008
Last Update Date: 08/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 E DUNDEE RD STE 300
WHEELING IL
60090-3119
US

IV. Provider business mailing address

350 E DUNDEE RD STE 300
WHEELING IL
60090-3119
US

V. Phone/Fax

Practice location:
  • Phone: 847-243-2110
  • Fax: 847-243-2118
Mailing address:
  • Phone: 847-243-2110
  • Fax: 847-243-2118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number036042276
License Number StateIL

VIII. Authorized Official

Name: DR. HOWARD N RUBIN
Title or Position: FAMILY DOCTOR
Credential: M.D.
Phone: 847-243-2110