PCC COMMUNITY WELLNESS CENTER (NPI# 1558387167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558387167 |
| Entity Type | Organization |
| Organization Name | PCC COMMUNITY WELLNESS CENTER |
| Other Organization Name | PCC DR. TONG HEALTH CENTER |
| Practice Address |
1 Erie Court Ste 6040 Oak Park IL 60302-2510 |
| Practice Telephone | 7083861301 |
| Practice Fax Number | 7083863053 |
| Mailing Telephone | 7083861301 |
| Mailing Fax Number | 7083863053 |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2020-01-23 |
| Authorized Official Name | ROBERT J URSO (PRESIDENT & CEO) |
| Authorized Official Telephone | 7083839786 |
| Is Organization Subpart | Y |
| Parent Organization Name | PCC COMMUNITY WELLNESS CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
=========004 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE PART A PROVIDER NUMBER | 141034 | 01 |
| Other Name | Type Code |
|---|---|
| Erie Court Health Center | Doing Business As Name - Organization |
| PCC Dr. Tong Health Center | 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 |
| 1255701942 | Pcc Community Wellness Center | Clinic/Center | 3030 N Mobile Ave, Chicago, IL 60634-4041 | 2015-10-07 |
| 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 |
| Street Address |
1 ERIE COURT STE 6040 |
| City | OAK PARK |
| State | IL |
| Zip Code | 60302-2510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700801966 | West Suburban Medical Center | Family Medicine | 1 Erie Court, Ste 6160, Oak Park, IL 60302 | 2006-07-12 |
| 1528237765 | Lakeshore Gastroenterology and Liver Disease Institute S.c. | Internal Medicine | 1 Erie Court, Suite 3100, Oak Park, IL 60614-8542 | 2008-02-21 |
| 1487724852 | West Suburban Gastroenterology S C | Internal Medicine | 1 Erie Court, Ste 3100, Oak Park, IL 60302 | 2006-11-09 |
| 1255354601 | West Suburban Eye Associates LLC | Ophthalmology | 1 Erie Court, Suite 6140, Oak Park, IL 60302 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306473244 | Tasha Kimberly Young | Counselor | 1216 N Austin Bvld, Oak Park, IL 60302 | 2020-03-23 |
| 1306492186 | Camiesa Rashida Rogers | Pharmacy Technician | 626 N Austin #7, Oak Park, IL 60302 | 2019-08-16 |
| 1326603887 | Right Choice Therapy LLC | Social Worker | 428 S. Scoville Avenue, Rear 1b, Oak Park, IL 60302 | 2019-05-09 |
| 1407328941 | Arundathi Bannur Suresh | Occupational Therapist | 3 Erie Court, West Suburban Medical Center, Oak Park, IL 60302 | 2018-12-21 |
| 1427537455 | Shannon Vogel | Occupational Therapist | 405 Home Ave Apt 207, Oak Park, IL 60302 | 2018-08-10 |
| 1568958726 | Loretto Hospital | Clinic/Center | 1000 Madison St, Oak Park, IL 60302 | 2018-07-10 |
| 1649783143 | Mary Joyce Arenas Lagatao | Nurse Practitioner | 101 Madison St, 3rd Floor, Oak Park, IL 60302 | 2017-11-07 |
| 1427578251 | Amanda Lam | Behavior Technician | 721 South Blvd., Suite 210, Oak Park, IL 60302 | 2017-06-22 |
| 1649790577 | Samantha Lotti | Acupuncturist | 1119 Pleasant St, Oak Park, IL 60302 | 2017-06-21 |
| 1770010480 | Robert Smith IIi | Behavior Technician | 412a S. Taylor Ave, Oak Park, IL 60302 | 2017-05-12 |
| Find all providers in zip 60302 | ||||
| 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 |
|---|---|---|---|---|
| 1508287673 | Pcc Community Wellness Center | Clinic/Center | 1 Erie Ct Ste 7140, Oak Park, IL 60302-2510 | 2013-12-17 |
| 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 |
| 1073536991 | Pcc Community Wellness Center | Clinic/Center | 14 W Lake St, Oak Park, IL 60302-2606 | 2006-07-25 |
| 1871516799 | Pcc Community Wellness Center | Clinic/Center | 14 Lake St, Oak Park, IL 60302-2606 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417567108 | Pillars Community Health | Clinic/Center | 15w458 91st St, Burr Ridge, IL 60527-6379 | 2020-08-06 |
| 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 |
| 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 | ||||
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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.