LEGACY MEDICAL CARE INC NPI 1750830162

NPI Information

NPI: 1750830162
Provider Name: LEGACY MEDICAL CARE INC
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 14D2167005

Address:
860 SUMMIT ST STE 241
ELGIN, IL
ZIP 60120
Phone: (847) 749-2248
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LEGACY MEDICAL CARE INC is a federally qualified health center (fqhc) clinic center in Elgin, IL. LEGACY MEDICAL CARE INC NPI is 1750830162. The provider is registered as an organization entity type.

The provider's business location address is:

860 SUMMIT ST STE 241
ELGIN, IL
ZIP 60120-339
Phone: (847) 749-2248
Fax: (847) 214-4912

The provider's authorized official is Melissa D'onorio .
The authorized official title is Ceo and has the following contact phone number (847) 749-2248.

The CLIA number assigned to this NPI record is 14D2167005 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/26/2016 and was last updated on 3/17/2018.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)		ILLINOIS	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: 5/5/2024

NPI Synchronization or Removal

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