PRIME MEDICAL CLINIC S.C.
NPI 1659815074
Family Medicine - Adult Medicine in Glenview, IL
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
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Prime Medical Clinic S.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Prime Medical Clinic S.C., which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Is Prime Medical Clinic S.C. enrolled in Medicare?
Yes. Prime Medical Clinic S.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Prime Medical Clinic S.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Prime Medical Clinic S.C., in Family Practice and Physical Therapist in Private Practice. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
# Prime Medical Clinic S.c. · NPI 1659815074
Adult Medicine organization in Glenview, Illinois. Organization record, active in the CMS NPPES registry since December 5, 2016.
## Identity
- **NPI:** 1659815074 (Entity type: Organization)
- **Enumerated:** December 5, 2016
- **Primary specialty:** Family Medicine - Adult Medicine · taxonomy 207QA0505X
- **Organization subpart:** No
- **Authorized official:** Konstantins Kociasvili, MEDICAL DOCTOR
## Practice location
- **Address:** 3633 W LAKE AVE STE 307, Glenview, IL 60026-5803
- **Phone:** (847) 626-8722 · **Fax:** (847) 316-9502
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), Physical Therapist in Private Practice (1); 1 practice at this address and 2 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 13, 2023
- **Other identifiers:** Medicaid 036135325 (IL)
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Source: [NPI Profile](https://npiprofile.com/npi/1659815074) · Data from the CMS NPPES public registry.