NPIMap

Organization Active NPI

Primecare Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
National Provider Identifier
1205374964
Registry record updated Oct 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PRIMECARE COMMUNITY HEALTH INC
Practice address
1431 N Western Ave
Suite 401
Chicago, IL 60622-1797
Phone
(773) 269-5540
Fax
(773) 269-5542
NPI assigned
Feb 2, 2017
Last updated
Oct 26, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joseph Moldovan
Title
Cfo/Coo
Phone
(312) 491-5034

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1431 N Western Ave
Suite 401
Chicago, IL 60622-1797

Mailing address

2232 N Clybourn Ave FL 3
Chicago, IL 60614-3193
Phone (312) 633-5841

National Provider Directory

National Provider Directory
Tax ID family
Elston4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2232 N Clybourn Ave
Fl 3
Chicago, IL 60614
Phone (773) 377-5492

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16494/brand/1/csg/1/fhir/r4

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508976000000",
    "number": "1205374964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 N CLYBOURN AVE FL 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143193",
            "telephone_number": "312-633-5841",
            "fax_number": "773-269-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 N WESTERN AVE",
            "address_2": "SUITE 401",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221797",
            "telephone_number": "773-269-5540",
            "fax_number": "773-269-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECARE COMMUNITY HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-02",
        "last_updated": "2017-10-26",
        "status": "A",
        "authorized_official_last_name": "MOLDOVAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CFO/COO",
        "authorized_official_telephone_number": "312-491-5034"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.