Pcc Community Wellness Center in Chicago - Federally Qualified Health Center (fqhc)
Pcc Community Wellness Center - NPI 1609892223
Pcc Community Wellness Center is a Federally Qualified Health Center (fqhc) in Chicago, Illinois. Pcc Community Wellness Center practices all healthcare services and medical treatments related to Federally Qualified Health Center (fqhc). The NPI Number for Pcc Community Wellness Center is 1609892223. The last update date is 2022-07-21.
Pcc Community Wellness Center's current location address is 5425 W Lake St, Chicago, Illinois. You can contact this provider via phone number 7733783347 and fax number 7733784028. The mailing address for Pcc Community Wellness Center is 5425 W Lake St, Chicago, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Pcc Community Wellness Center |
|---|---|
| Address | 5425 W Lake St, Chicago, Illinois |
| Phone Number | 7733783347 |
| Fax Number | 7733784028 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Urso J Robert |
| Telephone Number | 7083839786 |
NPI Number Detail
| NPI Number | 1609892223 |
|---|---|
| Provider Enumeration Date | 2006-07-15 |
| Last Updated Date | 2022-07-21 |
Provider Mailing Address Detail
| Address | 5425 W Lake St |
|---|---|
| City | Chicago |
| State | Illinois (IL) |
| Post Code | 606442342 |
| Phone Number | 7733783347 |
| Fax Number | 7733784028 |
Provider's Primary Taxonomy Detail
| Speciality | Federally Qualified Health Center (fqhc) |
|---|---|
| Taxonomy | 261Qf0400X |
| Licence No | 2 |
|
Definition: Provides primary and preventive care services in underserved areas, receiving certain federal funding grants. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 141889 | MEDICARE PART A PROVIDER NUMBE |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Pcc Community Wellness Center by the Centers for Medicare & Medicaid Services?
The Pcc Community Wellness Center has been assigned the NPI (National Provider Identifier) 1609892223 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you share the physical location details of Pcc Community Wellness Center?
The Pcc Community Wellness Center is situated at 5425 W Lake St, in the city of Chicago, state of IL, with the zip code 606442342.
What is the Pcc Community Wellness Center's specialty and taxonomy code?
The Pcc Community Wellness Center's specialty is Federally Qualified Health Center (fqhc), and the corresponding taxonomy code is 261Qf0400X.
On what date did the Centers for Medicare & Medicaid Services assign the 1609892223 to Pcc Community Wellness Center?
The Centers for Medicare & Medicaid Services assigned the 1609892223 to Pcc Community Wellness Center on 2006-07-15.
As of what date were the details related to Pcc Community Wellness Center most recently updated or revised?
The information pertaining to Pcc Community Wellness Center, including its address, specialty, and other relevant details, was last updated or revised on 2022-07-21.