Healthcare Provider Details

I. General information

NPI: 1053933184
Provider Name (Legal Business Name): PRIMARY HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2020
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 PLAINFIELD RD
WILLOWBROOK IL
60527-1705
US

IV. Provider business mailing address

980 PLAINFIRLAD ROAD
WILLOWBRROK IL
60527
US

V. Phone/Fax

Practice location:
  • Phone: 630-541-6679
  • Fax:
Mailing address:
  • Phone: 630-547-6679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FAROOQ ANWAR KHAN
Title or Position: PART OWNER
Credential: MD
Phone: 773-416-1013