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PRIME MEDICAL CLINIC S.C.
NPI 1659815074
Family Medicine - Adult Medicine in Glenview, IL

Active since December 05, 2016
3633 W LAKE AVE STE 307, GLENVIEW, IL 60026(847) 626-8722(847) 316-9502 Get Directions Write a Review

NPPES record last updated: January 13, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Prime Medical Clinic S.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIME MEDICAL CLINIC S.C. (NPI 1659815074) is a healthcare organization registered as an adult medicine in Glenview, Illinois and active in the NPI registry since December 2016. The organization lists Konstantins Kociasvili, Medical Doctor, as its authorized official.

NPPES Registry Identity

NPI1659815074
Entity TypeOrganization
Primary Taxonomy207QA0505X
Legal Business NamePRIME MEDICAL CLINIC S.C.
Location Address3633 W LAKE AVE STE 307Glenview, IL 60026-5803
Mailing Address333 W Dundee RdBuffalo Grove, IL 60089-3545 · (847) 243-0355
Phone(847) 626-8722
Fax(847) 316-9502
Organization SubpartNo
Authorized OfficialKonstantins KociasviliMedical Doctor · (773) 507-7434
Enumeration DateDecember 5, 2016
Last NPPES UpdateJanuary 13, 2023
NPPES CertifiedJanuary 13, 2023
✔ NPI 1659815074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
License✔ Licensed in IL · 036135325
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
3633 W LAKE AVE STE 307, Glenview, IL 60026
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Other Identifiers 1

Medicaid036135325IL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KONSTANTINS KOCIASVILI M.D.
Family Medicine (Adult Medicine)
3633 W LAKE AVE STE 307
GLENVIEW, IL 60026
Cook County (847) 626-8722
HEALTH BOX LTD
Physical Medicine & Rehabilitation
3633 W LAKE AVE STE 307
GLENVIEW, IL 60026
Cook County (847) 724-1777

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prime Medical Clinic S.C.'s NPI number?

The NPI number for Prime Medical Clinic S.C. is 1659815074. It was assigned to this organization in the NPPES registry on December 5, 2016.

Where is Prime Medical Clinic S.C. located?

Prime Medical Clinic S.C. is located at 3633 W Lake Ave Ste 307, Glenview, IL 60026. The listed phone number is (847) 626-8722.

What is Prime Medical Clinic S.C.'s specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

When was this NPI record last updated?

The NPPES record for Prime Medical Clinic S.C. was last updated on January 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.