PRIME MEDICAL IMAGING, LLC
NPI 1962974527
Physiological Laboratory in Mokena, IL

Active since December 20, 2018CLIA 14D2163642 · Waiver
10260 191ST ST, MOKENA, IL 60448(708) 215-3899 Get Directions Write a Review

NPPES record last updated: June 27, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 27, 2025, Dec 31, 2019, Dec 20, 2018 (3 updates tracked since 2018).

About Prime Medical Imaging, Llc NPPES

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

PRIME MEDICAL IMAGING, LLC (NPI 1962974527) is a healthcare organization registered as a physiological laboratory in Mokena, Illinois and active in the NPI registry since December 2018. The organization holds a CLIA Waiver certificate valid through March 18, 2027 and lists Marina Rossomakha, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1962974527
Entity TypeOrganization
Primary Taxonomy293D00000X
Legal Business NamePRIME MEDICAL IMAGING, LLC
Location Address10260 191ST STMokena, IL 60448-8801
Mailing Address8930 Waukegan Rd Ste 130Morton Grove, IL 60053-2132 · (847) 929-5460 · Fax (847) 929-5461
Organization SubpartNo
Authorized OfficialMarina RossomakhaCredentialing Specialist · (847) 929-5482
Enumeration DateDecember 20, 2018
Last NPPES UpdateJune 27, 20253 updates tracked since enumeration
NPPES CertifiedJune 27, 2025
NPI 1962974527 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysiological LaboratoryLaboratories
Taxonomy Code293D00000X
Definition
A laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services.
Also ListedRadiology · Diagnostic RadiologyTaxonomy 2085R0202X
10260 191ST ST, Mokena, IL 60448

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2163642

Prime Medical Imaging, L L C · Mokena, IL
Active · expires Mar 18, 2027
CLIA Number14D2163642
Laboratory TypeIndependent
Certificate Effective DateMarch 19, 2025
Certificate Expiration DateMarch 18, 2027
Laboratory DirectorRichard Kim M D
Laboratory Phone(847) 929-5460
Laboratory LocationPrime Medical Imaging, L L C10260 W 191st - Ste 106, Mokena, IL 60448
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 41

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml Q9967
Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.
19,100 services173 patients
Injection, gadobutrol, 0.1 ml A9585
Gadobutrol is a contrast agent used during MRI scans to help provide clearer images. It's injected into your vein before the scan. This helps doctors to see certain areas more clearly for better diagnosis. It's generally safe with few side effects.
15,770 services179 patients
Screening 3d breast mammography 77063
Screening 3D breast mammography is a procedure that uses low-dose X-rays to create detailed images of the breast. This allows for early detection of any unusual changes or growths. It's a non-invasive, outpatient procedure that typically takes about 30 minutes.
253 services253 patients
Screening mammography 77067
Screening mammography is a preventative measure that uses low-dose X-rays to take images of the chest area. It's a key tool in early detection of abnormalities, helping to identify issues before they become symptomatic. It is recommended annually for certain age groups.
253 services253 patients
Dxa bone density measurement of hip, pelvis, spine 77080
A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.
180 services180 patients
Mri scan of lower spinal canal without contrast 72148
An MRI scan of the lower spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to produce detailed images of your lower spine. This helps identify issues like disc problems, tumors, or nerve conditions. No dye is used.
123 services123 patients

Other Providers at the Same Location NPPES 4

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

Urology (Urogynecology and Reconstructive Pelvic Surgery)
10260 191ST ST, STE. 100
MOKENA, IL 60448
Obstetrics & Gynecology
10260 191ST ST, SUITE 100
MOKENA, IL 60448
Obstetrics & Gynecology
10260 191ST ST, STE 100
MOKENA, IL 60448
Obstetrics & Gynecology
10260 191ST ST, SUITE 100
MOKENA, IL 60448

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 Imaging, LLC's NPI number?

The NPI number for Prime Medical Imaging, LLC is 1962974527. It was assigned to this organization in the NPPES registry on December 20, 2018.

Where is Prime Medical Imaging, LLC located?

Prime Medical Imaging, LLC is located at 10260 191st St, Mokena, IL 60448. The listed phone number is (708) 215-3899.

What is Prime Medical Imaging, LLC's specialty?

The primary specialty registered for this NPI is Physiological Laboratory with taxonomy code 293D00000X.

Does Prime Medical Imaging, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2163642) is associated with this NPI, valid through March 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Prime Medical Imaging, LLC was last updated on June 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.