PRIMECARE COMMUNITY HEALTH, INC. (NPI# 1356622500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356622500 |
| Entity Type | Organization |
| Organization Name | PRIMECARE COMMUNITY HEALTH, INC. |
| Other Organization Name | PRIMECARE HAMLIN |
| Practice Address |
1920 N Hamlin Ave Chicago IL 60647-3411 |
| Mailing Address |
2232 N Clybourn Ave Fl 3 Chicago IL 60614-3193 |
| Practice Telephone | 7737727202 |
| Practice Fax Number | 7737727244 |
| Mailing Telephone | 3126335841 |
| Mailing Fax Number | 7732695500 |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2017-10-26 |
| Authorized Official Name | JOSEPH MOLDOVAN (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 3124915034 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| PrimeCare Hamlin | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730235870 | Primecare Community Health, Inc. | Family Medicine | 1649 N Pulaski Rd, Chicago, IL 60639-5207 | 2007-01-25 |
| 1437440229 | Primecare Community Health, Inc. | Family Medicine | 5647 W Addison St, Chicago, IL 60634-4403 | 2011-04-27 |
| 1558532739 | Primecare Community Health, Inc. | Family Medicine | 1431 N Western Ave, Suite 401, Chicago, IL 60622-1797 | 2008-03-17 |
| 1992851067 | Primecare Community Health, Inc. | Family Medicine | 3924 W Fullerton Ave, Chicago, IL 60647-2228 | 2007-01-25 |
| 1225010911 | Primecare Community Health, Inc. | Family Medicine | 1431 N Western Ave, Ste 406, Chicago, IL 60622-1797 | 2005-11-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PRIMECARE COMMUNITY HEALTH, INC. | 2232 N Clybourn Ave, 3rd Floor, Chicago, IL 60614-3193 |
| Street Address |
1920 N HAMLIN AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60647-3411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700234630 | Mayra A Bailon | Social Worker | 1920 N Hamlin Ave, Chicago, IL 60647-3411 | 2016-06-01 |
| 1922418334 | Miranda Victoria De Loof | Nurse Practitioner | 1920 N Hamlin Ave, Chicago, IL 60647-3411 | 2014-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164035879 | Scott Spine and Health LLC | Chiropractor | 2560 W. Armitage Ave, Unit C2, Chicago, IL 60647 | 2020-08-24 |
| 1003424458 | Emily Gleesing | Physical Therapist | 1923 N Western Ave, Chicago, IL 60647 | 2020-07-21 |
| 1699301358 | Marcella Guzman P.C. | Dentist | 3236 W. Fullerton Ave., Chicago, IL 60647 | 2020-03-13 |
| 1740772342 | Envision Unlimited | Case Management | 2646 N Washtenaw Ave # 3n, Chicago, IL 60647 | 2018-05-31 |
| 1992297535 | Envision Unlimited | Case Management | 2646 N Washtenaw Ave # 2n, Chicago, IL 60647 | 2018-05-30 |
| 1942704580 | Team Rehabilitation Il15, LLC | Physical Therapist | 1923 N Western Avenue, Chicago, IL 60647 | 2018-03-20 |
| 1023517331 | Chicago Medical Healthcare Group, S.c. | Family Medicine | 3648 W Armitage Avenue, Chicago, IL 60647 | 2018-02-02 |
| 1023537693 | Erin Frommeyer | Physician Assistant | 2228 W Dickens Avenue, Chicago, IL 60647 | 2017-09-15 |
| 1457872475 | Stefanie Paola Maurtua | Behavioral Analyst | 2448 West Bloomingdale Ave., Apt 2e, Chicago, IL 60647 | 2017-06-29 |
| 1700322922 | Lumen Optical Illinois 4, LLC | Optometrist | 2420 N Elston, Bucktown, IL 60647 | 2017-01-11 |
| Find all providers in zip 60647 | ||||
| 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 |
|---|---|---|---|---|
| 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.