LEGACY MEDICAL CARE INC (NPI# 1104375518) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104375518 |
| Entity Type | Organization |
| Organization Name | LEGACY MEDICAL CARE INC |
| Practice Address |
1715 W Algonquin Rd Mount Prospect IL 60056-5401 |
| Practice Telephone | 8477492248 |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2016-09-26 |
| Authorized Official Name | MRS. MELISSA DONORIO (CEO) |
| Authorized Official Telephone | 8477492248 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
IL | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003365412 | Legacy Medical Care Inc | Clinic/Center | 519 Dundee Ave, East Dundee, IL 60118-1642 | 2016-09-26 |
| 1750830162 | Legacy Medical Care Inc | Clinic/Center | 860 Summit St Ste 241, Elgin, IL 60120-4339 | 2016-09-26 |
| 1497181697 | Legacy Medical Care Inc | Clinic/Center | 121 S. Wilke Rd, Suite 600, Arlington Heights, IL 60005 | 2013-09-19 |
| 1558810960 | Legacy Medical Care Inc | Clinic/Center | 6620 Barrington Rd, Hanover Park, IL 60133-3935 | 2016-09-26 |
| 1659820066 | Legacy Medical Care Inc | Clinic/Center | 526 Main St, West Chicago, IL 60185-2843 | 2016-09-26 |
| 1902355316 | Legacy Medical Care Inc | Clinic/Center | 2055 W Army Trail Rd, Addison, IL 60101-1478 | 2016-09-26 |
| 1205385614 | Legacy Medical Care Inc | Clinic/Center | 229 W Grand Ave, Suite T, Bensenville, IL 60106-3399 | 2016-09-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LEGACY MEDICAL CARE INC. | 121 S Wilke Rd 6th Flr, Arlington Heights, IL 60005-1533 |
| Street Address |
1715 W ALGONQUIN RD |
| City | MOUNT PROSPECT |
| State | IL |
| Zip Code | 60056-5401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063509875 | Charlene Appleson | Pediatrics | 1715 W Algonquin Rd, Mount Prospect, IL 60056-5401 | 2006-10-05 |
| 1578796843 | Access Community Health Network | Clinic/Center | 1715 W Algonquin Rd, Mount Prospect, IL 60056-5401 | 2009-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023649829 | Blocki and Bashford Dental, LLC | Dentist | 200 E. Evergreen, Suite 129, Mt. Prospect, IL 60056 | 2020-01-30 |
| 1740745934 | Luminate Therapy Group of Illinois, LLC | Behavioral Analyst | 580 Slawin Court, Mt. Prospect, IL 60056 | 2019-02-01 |
| 1952884009 | Erin Kathleen Neal | Social Worker | 1550 Bishop Court, Mount Prospect, IL 60056 | 2018-09-13 |
| 1215431028 | Teandra Gelemer Delancy | Social Worker | Kenneth Young Center, 1585 West Dempster St, Mt. Prospect, IL 60056 | 2018-03-19 |
| 1578071650 | Azk Transportation Inc | Non-emergency Medical Transport (VAN) | 415 E Prospect Ave, 3c, Mount Prospect, IL 60056 | 2018-01-11 |
| 1275059859 | Sara Tyburski | Psychologist | 701 W Gregory, Mount Prospect, IL 60056 | 2017-08-16 |
| 1487197257 | Roma R D'silva | General Practice | 608 South Noah Terrace, Mount Prospect, IL 60056 | 2016-11-29 |
| 1568918159 | Georgeshia Norwood | Social Worker | 1820 West Dempster, Mount Prospect, IL 60056 | 2016-09-01 |
| 1568919025 | Scott G Smoron Dds Msd Ltd | Dentist | 421 W. Prospect Ave., Mount Prospect, IL 60056 | 2016-09-01 |
| 1568918365 | Kathleen Huttner | Counselor | 1820 W. Dempser, Kenneth Young Center, Mount Prospect, IL 60056 | 2016-08-31 |
| Find all providers in zip 60056 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578796843 | Access Community Health Network | Clinic/Center | 1715 W Algonquin Rd, Mount Prospect, IL 60056-5401 | 2009-09-02 |
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|---|---|---|---|---|
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| 1871117937 | Primecare Community Health Inc | Clinic/Center | 1431 N Western Ave Ste 101, Chicago, IL 60622-7712 | 2020-06-04 |
| 1639791569 | Community Health Partnership of Illinois | Clinic/Center | 201 W Kenyon Rd Bldg D, Champaign, IL 61820-7892 | 2020-05-14 |
| 1407482219 | Access Community Health Network | Clinic/Center | 6020 W Diversey Ave Bldg West, Chicago, IL 60639-1108 | 2020-03-13 |
| 1235769704 | Greater Elgin Family Care Center | Clinic/Center | 451 N Mclean Blvd, Elgin, IL 60123-3239 | 2020-01-23 |
| 1710517537 | Greater Elgin Family Care Center Integrated Health Home | Clinic/Center | 1100 Shirley Ave, Streamwood, IL 60107-3068 | 2020-01-21 |
| 1215578109 | Board of Trustees of Southern Illinois University | Clinic/Center | 205 S 24th St Ste 100, Quincy, IL 62301-4446 | 2019-10-02 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1427600345 | The Board of Trustees of The University of Illinois | Clinic/Center | 6835 S Normal Blvd, Chicago, IL 60621-2535 | 2019-07-11 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT PROSPECT |
| Zip Code | 60056 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.