PCC COMMUNITY WELLNESS CENTER (NPI# 1255701942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255701942 |
| Entity Type | Organization |
| Organization Name | PCC COMMUNITY WELLNESS CENTER |
| Other Organization Name | PCC COMMUNITY WELLNESS CENTER AT STEINMETZ |
| Practice Address |
3030 N Mobile Ave Chicago IL 60634-4041 |
| Mailing Address |
6201 Roosevelt Rd Berwyn IL 60402-1108 |
| Practice Telephone | 7084063041 |
| Mailing Telephone | 7084063056 |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2015-10-07 |
| Authorized Official Name | MR. ROBERT J URSO (PRESIDENT AND CEO) |
| Authorized Official Telephone | 7083839786 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| PCC Community Wellness Center at Steinmetz | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114498540 | Pcc Community Wellness Center | Clinic/Center | 115 N Parkside Ave Fl 1, Chicago, IL 60644-3040 | 2018-12-11 |
| 1508287673 | Pcc Community Wellness Center | Clinic/Center | 1 Erie Ct Ste 7140, Oak Park, IL 60302-2510 | 2013-12-17 |
| 1487670097 | Pcc Community Wellness Center | Clinic/Center | 5359 E Fullerton Ave, Chicago, IL 60639-1450 | 2006-07-15 |
| 1295385490 | Pcc Community Wellness Center | Clinic/Center | 4534 S Western Ave, Chicago, IL 60609-3027 | 2019-09-19 |
| 1689158271 | Pcc Community Wellness Center | Case Management | 14 Lake St, Oak Park, IL 60302-2606 | 2018-09-19 |
| 1548671563 | Pcc Community Wellness Center | Clinic/Center | 6201 Roosevelt Rd, Berwyn, IL 60402-1108 | 2014-05-13 |
| 1750621769 | Pcc Community Wellness Center | Clinic/Center | 3 Erie Ct, Suite 1300, Oak Park, IL 60302-2519 | 2013-02-28 |
| 1427365311 | Pcc Community Wellness Center | Clinic/Center | 120 S Marion St, Oak Park, IL 60302-2809 | 2010-09-13 |
| 1962633081 | Pcc Community Wellness Center | Clinic/Center | 1044 N Francisco Ave, Chicago, IL 60622-2743 | 2009-08-06 |
| 1760630750 | Pcc Community Wellness Center | Clinic/Center | 3456 W Franklin Blvd, Chicago, IL 60624-1308 | 2008-09-03 |
| Street Address |
3030 N MOBILE AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60634-4041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962827964 | Carmen Ochoa-galindo | Counselor | 3030 N Mobile Ave, Pcc Community Wellness Center, Chicago, IL 60634-4041 | 2014-02-27 |
| 1235612383 | Megan Cairns Tress | Nurse Practitioner | 3030 N Mobile Ave, Chicago, IL 60634-4041 | 2018-09-13 |
| 1134661366 | Kimberly Finnegan | Nurse Practitioner | 3030 N Mobile Ave, Pcc Community Wellness Center, Chicago, IL 60634-4041 | 2016-11-04 |
| 1619325578 | Madalyn Cecile Kovarik | Family Medicine | 3030 N Mobile Ave, Chicago, IL 60634-4041 | 2016-06-01 |
| 1154734853 | Emma Worringer | Family Medicine | 3030 N Mobile Ave, Chicago, IL 60634-4041 | 2014-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356987333 | Alejandra Carrera | Student in an Organized Health Care Education/Training Program | 6417 W Irving Park Rd., Chicago, IL 60634 | 2019-11-25 |
| 1861977456 | Virtue Counseling Center | Counselor | 2904 N Parkside, Chicago, IL 60634 | 2018-09-28 |
| 1770931255 | Dynamic Transport Solutions LLC | Non-emergency Medical Transport (VAN) | 6109 W. Barry, Chicago, IL 60634 | 2016-05-25 |
| 1104284710 | Ez Dental | Dental Laboratory | 5621 W.montrose Avenue, Chicago, IL 60634 | 2016-02-10 |
| 1285075432 | Chicago Medical Transportation | Non-emergency Medical Transport (VAN) | 3033 N. Nordica Ave., Chicago, IL 60634 | 2013-07-16 |
| 1083985725 | Maria C. Rodriguez | Lactation Consultant, Non-RN | 6216 W. School St., Chicago, IL 60634 | 2012-01-25 |
| 1295066827 | Angie Harris | Occupational Therapist | 3339 N. Octavia, Chicago, IL 60634 | 2010-01-21 |
| 1205169802 | Belmont Dental P.C. | Dentist | 5611 W. Belmont Ave., Chicago, IL 60634 | 2009-09-14 |
| 1568605178 | Henry Biskup | Radiologic Technologist | 3105 N. Austin Ave., Chicago, IL 60634 | 2009-04-13 |
| 1306086624 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 3615 N. Central Ave, Chicago, IL 60634 | 2009-02-26 |
| Find all providers in zip 60634 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1932724390 | Friend Family Health Center, Inc | Clinic/Center | 7355 S Jeffery Blvd, Chicago, IL 60649-3121 | 2020-06-11 |
| 1871117937 | Primecare Community Health Inc | Clinic/Center | 1431 N Western Ave Ste 101, Chicago, IL 60622-7712 | 2020-06-04 |
| 1407482219 | Access Community Health Network | Clinic/Center | 6020 W Diversey Ave Bldg West, Chicago, IL 60639-1108 | 2020-03-13 |
| 1427600345 | The Board of Trustees of The University of Illinois | Clinic/Center | 6835 S Normal Blvd, Chicago, IL 60621-2535 | 2019-07-11 |
| 1114498540 | Pcc Community Wellness Center | Clinic/Center | 115 N Parkside Ave Fl 1, Chicago, IL 60644-3040 | 2018-12-11 |
| 1427523125 | Howard Brown Health Center | Clinic/Center | 3533 W North Ave Ste 1, Chicago, IL 60647-7573 | 2018-10-09 |
| 1336626936 | Heartland International Health Center | Clinic/Center | 1631 W Jonquil Ter, Chicago, IL 60626-1103 | 2018-07-26 |
| 1760975304 | Inner-city Muslim Action Network | Clinic/Center | 2744 W 63rd St Bldg 2, Chicago, IL 60629-2343 | 2018-06-08 |
| 1417473851 | Howard Brown Health Center | Clinic/Center | 2800 N Sheridan Rd Ste 211, Chicago, IL 60657-6161 | 2017-08-17 |
| 1487193181 | Mile Square Englewood/cook Satellite Health and Wellness Center | Clinic/Center | 8150 S Bishop St, Chicago, IL 60620-3854 | 2017-02-15 |
| Find all providers in CHICAGO | ||||
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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.