Primesource Healthcare Systems, Inc.

NPI #1497704126 in Buffalo Grove, Illinois

Provider Information

NPI Number: 1497704126
Entity Type: Organization
Organization Name: Primesource Healthcare Systems, Inc.
Primary Specialty: Podiatrist
Enumeration Date: May 9, 2006
Last Updated: Feb 19, 2014

Practice Location

Address: 2100 EAST LAKE COOK ROAD
Address 2: SUITE 1100
City: Buffalo Grove
State: Illinois
ZIP Code: 60089-1815
Phone: (800) 317-0711

Authorized Official

Name: MR. DAVID FLEMING
Title: PRESIDENT & CEO
Phone: (800) 317-0711

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X
Optometrist	152W00000X
Audiologist	231H00000X
Optometrist - Vision Therapy — Vision Therapy	152WV0400X
Dentist - General Practice — General Practice	1223G0001X
Podiatrist	213E00000X	Primary

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