NPIMap

Organization Active NPI

PCC Community Wellness Center

Doing business as PCC Sports Medicine and Prenatal Wellness Clinic

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
National Provider Identifier
1427635358
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PCC COMMUNITY WELLNESS CENTER
Doing business as
PCC Sports Medicine and Prenatal Wellness Clinic
Practice address
5425 W Lake St
Chicago, IL 60644-2342
Phone
(708) 434-4007
NPI assigned
Mar 26, 2021
Last updated
Oct 8, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
PCC COMMUNITY WELLNESS CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Authorized official

Name
Alyssa N Sianghio
Title
President and Ceo
Phone
(708) 383-9786

Specialties & licenses 1

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

Addresses

Primary practice location

5425 W Lake St
Chicago, IL 60644-2342

Mailing address

5425 W Lake St
Chicago, IL 60644-2342
Phone (708) 434-4007

Other practice location 1

1 Erie Ct Ste 6160
Oak Park, IL 60302-2510
Phone (708) 434-4007

Other names 1

  • PCC Sports Medicine and Prenatal Wellness Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Berwyn Direct

National Provider Directory

National Provider Directory
Tax ID family
PCC Community Wellness Center21 organizations share this tax ID, including this one
Part of
PCC Community Wellness Center

Other organizations with this tax ID 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759881600000",
    "number": "1427635358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 W LAKE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606442342",
            "telephone_number": "708-434-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 W LAKE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606442342",
            "telephone_number": "708-434-4007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Erie Ct Ste 6160",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603022510",
            "country_code": "US",
            "telephone_number": "708-434-4007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PCC COMMUNITY WELLNESS CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PCC COMMUNITY WELLNESS CENTER",
        "enumeration_date": "2021-03-26",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A",
        "authorized_official_last_name": "SIANGHIO",
        "authorized_official_first_name": "ALYSSA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "708-383-9786"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Berwyn",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1 Erie Ct Ste 7140",
            "city": "Oak Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "603022510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "PCC Sports Medicine and Prenatal Wellness Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 8, 2025; 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.