LEGACY MEDICAL CARE INC (NPI# 1558810960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558810960 |
| Entity Type | Organization |
| Organization Name | LEGACY MEDICAL CARE INC |
| Practice Address |
6620 Barrington Rd Hanover Park IL 60133-3935 |
| 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 |
| 1104375518 | Legacy Medical Care Inc | Clinic/Center | 1715 W Algonquin Rd, Mount Prospect, IL 60056-5401 | 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 |
6620 BARRINGTON RD |
| City | HANOVER PARK |
| State | IL |
| Zip Code | 60133-3935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598009417 | Reumah E Ravoori | Physician Assistant | 6620 Barrington Rd, Hanover Park, IL 60133-3935 | 2012-11-15 |
| 1053960765 | Lizbeth Angeles Trevino | Nurse Practitioner | 6620 Barrington Rd, Hanover Park, IL 60133-3935 | 2019-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215302922 | Mangal Dhami | Pharmacist | 1877 Grosse Pointe Circle, Hanove Park, IL 60133 | 2015-12-07 |
| 1649588260 | Church Street Station Skilled Nursing and Living Center, LLC | Skilled Nursing Facility | 2000 W. Lake St., Hanover Park, IL 60133 | 2010-09-16 |
| 1578603395 | Shyam V N Rao | Dentist | 1601 Tanglewood Avenue, Hanover Park, IL 60133 | 2007-02-08 |
| 1851458939 | Robert Jan Bazan | Dentist | 2260 W Irving Pk Rd, Hanover Pk, IL 60133 | 2007-01-02 |
| 1215018635 | Alexian Brothers Corporate Health Services | Clinic/Center | 1515 W Lake Street, Ste 100, Hanover Park, IL 60133 | 2006-10-19 |
| 1225120462 | Hanover Park Physical Medicine & Rehabilitation Ltd | Chiropractor | 1802 Irving Park Road, Hanover Park, IL 60133 | 2006-09-28 |
| 1447350830 | Ismail E Atcha | Internal Medicine | 5420 Cloverdale Road, Hanover Park, ILLINOIS 60133 | 2006-09-25 |
| 1013013374 | Antonio B Cruz | General Practice | 1601 Tanglewood, Suite 106, Hanover Park, IL 60133 | 2006-09-15 |
| 1326143223 | Matthew J Faith | Dentist | 1645 Irving Park Road, Hanover Park, IL 60133 | 2006-09-14 |
| 1992818827 | Ketan Narandas Jobanputra | Obstetrics & Gynecology | 1515 West Lake Street, #208, Alexian Brothers' Hospital Pavilion, Hanover Park, IL 60133 | 2006-08-16 |
| Find all providers in zip 60133 | ||||
| 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 |
|---|---|---|---|---|
| 1063963031 | Greater Elgin Family Care Center | Clinic/Center | 1701 Greenbrook Blvd, Hanover Park, IL 60133-5338 | 2016-10-14 |
| 1659602837 | Greater Elgin Family Care Center | Clinic/Center | 1750 Laurel Ave, Hanover Park, IL 60133-3316 | 2010-01-27 |
| 1679809099 | Greater Elgin Family Care Center | Clinic/Center | 2150 Laurel Ave, Hanover Park, IL 60133-3251 | 2009-10-20 |
| 1295060531 | Greater Elgin Family Care Center | Clinic/Center | 2100 Elm Ave, Hanover Park, IL 60133-3808 | 2009-10-05 |
| 1861885949 | Greater Elgin Family Care Center | Clinic/Center | 1515 E Lake St, Hanover Park, IL 60133-4869 | 2015-03-12 |
| 1407014046 | Aunt Martha's Youth Service Center, Inc | Clinic/Center | 1515 Lake St, Hanover Park, IL 60133-4896 | 2008-05-30 |
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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 | HANOVER PARK |
| Zip Code | 60133 |
Please comment or provide details below to improve the information on LEGACY MEDICAL CARE INC.
| 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.