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General NPI Number Information
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NPI Number | 1962590216
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE MEDICAL ASSOCIATES LTD
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 03/21/2011
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Provider Practice Location Address
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Address Line | 1460 N HALSTED ST SUITE 202
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City | CHICAGO
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State | IL
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Zip | 60642-2605
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Country | US
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Telephone | 773-871-4409
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Fax | 773-871-3608
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Provider Business Mailing Address
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Address Line | 1460 N HALSTED ST SUITE 202
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City | CHICAGO
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State | IL
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Zip | 60642-2605
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Country | US
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Telephone | 773-871-4409
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Fax | 773-871-3608
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT G PERLMUTER
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Credential | M.D., FACP
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Telephone | 773-871-4409
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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