PCC COMMUNITY WELLNESS CENTER NPI 1295385490

NPI Information

NPI: 1295385490
Provider Name: PCC COMMUNITY WELLNESS CENTER
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
4534 S WESTERN AVE
CHICAGO, IL
ZIP 60609
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 1295385490. The provider is registered as an organization entity type.

The provider's business location address is:

4534 S WESTERN AVE
CHICAGO, IL
ZIP 60609-027
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 9/19/2019 and was last updated on 9/19/2019.

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

NPI Synchronization or Removal

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