PCC COMMUNITY WELLNESS CENTER (NPI# 1871516799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871516799 |
| Entity Type | Organization |
| Organization Name | PCC COMMUNITY WELLNESS CENTER |
| Practice Address |
14 Lake St Oak Park IL 60302-2606 |
| Practice Telephone | 7083830113 |
| Practice Fax Number | 7083831378 |
| Mailing Telephone | 7083830113 |
| Mailing Fax Number | 7083831378 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ROBERT J URSO (PRESIDENT 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 |
| 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 |
14 LAKE ST |
| City | OAK PARK |
| State | IL |
| Zip Code | 60302-2606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548254972 | Ralph G. Ryan | Internal Medicine | 14 Lake St, Oak Park, IL 60302-2606 | 2005-08-31 |
| 1962026005 | Kathryn Elizabeth Ryan Nutting | Student in an Organized Health Care Education/Training Program | 14 Lake St, Oak Park, IL 60302-2606 | 2020-06-04 |
| 1972127165 | Jacqueline Marcella Greene-roper | Student in an Organized Health Care Education/Training Program | 14 Lake St, Oak Park, IL 60302-2606 | 2020-06-03 |
| 1881215960 | Jennifer Nudo | Social Worker | 14 Lake St, Oak Park, IL 60302-2606 | 2020-04-30 |
| 1891356721 | Maryam A Syed | Registered Nurse | 14 Lake St, Oak Park, IL 60302-2606 | 2019-06-21 |
| 1962060723 | Elizabeth Jeanne Burgess | Student in an Organized Health Care Education/Training Program | 14 Lake St, Oak Park, IL 60302-2606 | 2019-06-05 |
| 1689158271 | Pcc Community Wellness Center | Case Management | 14 Lake St, Oak Park, IL 60302-2606 | 2018-09-19 |
| 1760973515 | Leslie Smebak | Student in an Organized Health Care Education/Training Program | 14 Lake St, Oak Park, IL 60302-2606 | 2018-05-28 |
| 1811488679 | Morgan Colleen Beatty | Student in an Organized Health Care Education/Training Program | 14 Lake St, Oak Park, IL 60302-2606 | 2018-05-28 |
| 1104344431 | Kimberly Zoellick | Nurse Practitioner | 14 Lake St, Oak Park, IL 60302-2606 | 2017-09-07 |
| Find all providers in the same location | ||||
| 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 |
| 1558387167 | Pcc Community Wellness Center | Clinic/Center | 1 Erie Court, Ste 6040, Oak Park, IL 60302-2510 | 2006-07-15 |
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|---|---|---|---|---|
| 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 |
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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.