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General NPI Number Information
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NPI Number | 1043109754
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Entity Type | Organization
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Legal Business Name | PRIME HEALTHCARE ASSOCIATES, INC.
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 1 DEARBORN SQ STE 639
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City | KANKAKEE
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State | IL
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Zip | 60901-3932
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Country | US
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Telephone | 815-573-5168
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Fax | 815-573-5188
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Provider Business Mailing Address
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Address Line | 1 DEARBORN SQ STE 639
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City | KANKAKEE
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State | IL
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Zip | 60901-3932
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Country | US
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Telephone | 815-573-5168
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Fax | 815-573-5188
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTIAN OKEZIE
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Credential | DR
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Telephone | 815-573-5168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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