PCC COMMUNITY WELLNESS CENTER NPI 1255701942

NPI Information

NPI: 1255701942
Provider Name: PCC COMMUNITY WELLNESS CENTER

Doing Business As: PCC COMMUNITY WELLNESS CENTER AT STEINMETZ

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
3030 N MOBILE AVE
CHICAGO, IL
ZIP 60634
Phone: (708) 406-3041
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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 1255701942. The provider is registered as an organization entity type.
The provider Is Doing Business As Pcc Community Wellness Center At Steinmetz.

The provider's business location address is:

3030 N MOBILE AVE
CHICAGO, IL
ZIP 60634-041
Phone: (708) 406-3041

The provider's authorized official is Robert J Urso .
The authorized official title is President And Ceo and has the following contact phone number (708) 383-9786.

The CLIA number assigned to this NPI record is 14D2103249 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/7/2015 and was last updated on 10/7/2015.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally 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

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