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PCC COMMUNITY WELLNESS CENTER NPI 1114498540


NPI Information

NPI: 1114498540
Provider Name: PCC COMMUNITY WELLNESS CENTER
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
115 N PARKSIDE AVE FL 1
CHICAGO, IL
ZIP 60644
Phone: (708) 406-3056
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PCC COMMUNITY WELLNESS CENTER is a federally qualified health center (fqhc) clinic center in Chicago, IL. PCC COMMUNITY WELLNESS CENTER NPI is 1114498540. The provider is registered as an organization entity type.

The provider's business location address is:

115 N PARKSIDE AVE FL 1
CHICAGO, IL
ZIP 60644-040
Phone: (708) 406-3056
Fax: (708) 406-3051

The provider's authorized official is Kathleen A Hand .
The authorized official title is Financial Analyst and has the following contact phone number (708) 406-3056.

The enumeration date for this NPI number is 12/11/2018 and was last updated on 12/11/2018.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.