PRIMECARE COMMUNITY HEALTH INC. NPI 1356622500

NPI Information

PRIMECARE COMMUNITY HEALTH, INC. is a federally qualified health center (fqhc) clinic center in Chicago, IL. PRIMECARE COMMUNITY HEALTH, INC. NPI is 1356622500. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Primecare Hamlin.

The provider's business location address is:

1920 N HAMLIN AVE
CHICAGO, IL
ZIP 60647-411
Phone: (773) 772-7202
Fax: (773) 772-7244

The provider's authorized official is Joseph Moldovan .
The authorized official title is Chief Executive Officer and has the following contact phone number (312) 491-5034.

The enumeration date for this NPI number is 9/1/2011 and was last updated on 10/26/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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