# PRIME CARE MEDICAL AND PHYSICAL THERAPY CENTERS, S.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689904039
- **Authorized official:** PETER PAPADOPOULOS (BUSINESS MANAGER)
- **Authorized official phone:** (773) 878-3674

## Contact information

- **Practice address:** 1719 W 18TH ST, CHICAGO, IL 60608-1913
- **Practice address phone:** (312) 421-7010
- **Mailing address:** PO BOX 56590, CHICAGO, IL 60656-0590
- **Mailing address phone:** (773) 878-3674

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | IL | Yes |

## Other

- **Enumeration date:** 01/07/2010
- **Last updated:** 01/07/2010