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Organization
PRI-MED MEDICAL CENTER S C
Active
Organization
PRI-MED MEDICAL CENTER S C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIRIN ARIF KHAN M.D. (PRESIDENT)
(708) 226-4961
Entity
Organization
Contact information
Practice address
10715 W 159TH ST, ORLAND PARK, IL 60467-4531
(708) 226-4961
(708) 364-9301
Mailing address
PO BOX 527, PALOS PARK, IL 60464-0527
(708) 226-4961
(708) 364-9301
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036085803
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036085803
—
IL
01
—
11023950
MEDICARE RAILROAD
IL
Enumeration date
06/23/2008
Last updated
04/24/2010
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