Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Prime Medical Clinic SC

Organization Adult Medicine Physician · NPI 1659815074

Prime Medical Clinic SC is an Adult Medicine Physician in Glenview, Illinois. Licensed in Illinois. Registered with an NPI since 2016.

Licensed in
IL
In the registry since
2016

Practice location Address checks out

3633 W Lake Ave Ste 307
Glenview, IL 60026-5803
Phone: (847) 626-8722
Fax: (847) 316-9502
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Medicine Physician (primary) Taxonomy 207QA0505X · Licence 036135325 (IL)

Record details

NPI number1659815074
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Konstantins Kociasvili — Medical Doctor · (773) 507-7434
NPI enumeratedDecember 5, 2016
Last updated in NPPESJanuary 13, 2023
Certification dateJanuary 13, 2023
Mailing address333 W Dundee Rd, Buffalo Grove, IL 60089-3545

Other providers in Glenview