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PRIMECARE COMMUNITY HEALTH INC NPI 1700230398


NPI Information

NPI: 1700230398
Provider Name: PRIMECARE COMMUNITY HEALTH INC
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
1127 N OAKLEY BLVD
2ND FLOOR
CHICAGO, IL
ZIP 60622
Phone: (312) 633-5841
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PRIMECARE COMMUNITY HEALTH INC is a federally qualified health center (fqhc) clinic center in Chicago, IL. PRIMECARE COMMUNITY HEALTH INC NPI is 1700230398. The provider is registered as an organization entity type.

The provider's business location address is:

1127 N OAKLEY BLVD
2ND FLOOR
CHICAGO, IL
ZIP 60622-507
Phone: (312) 633-5841

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

The enumeration date for this NPI number is 4/20/2016 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:

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

Other Identifiers

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

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1781855MEDICARE OSCAR/CERTIFICATIONILLINOIS
2324020MEDICARE OSCAR/CERTIFICATIONILLINOIS

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.