NPIMap

Organization Active NPI

PCC Community Wellness Center

Doing business as PCC Community Wellness Center at Loretto Hospital

  • Federally Qualified Health Center (FQHC)
  • Oak Park, IL
National Provider Identifier
1508287673
Registry record updated Jan 9, 2026
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 Community Wellness Center at Loretto Hospital
PCC Community Wellness Center at West Suburban
Practice address
1 Erie CT Ste 7120
Oak Park, IL 60302-2510
Phone
(773) 537-0020
Fax
(773) 537-0029
NPI assigned
Dec 17, 2013
Last updated
Jan 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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 Primary

Addresses

Primary practice location

1 Erie CT Ste 7120
Oak Park, IL 60302-2510

Mailing address

14 Lake St
Oak Park, IL 60302-2606
Phone (708) 383-0113

Other names 2

  • PCC Community Wellness Center at Loretto Hospital Doing business as
  • PCC Community Wellness Center at West Suburban Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140905001576 IL Part A Provider - Federally Qualified Health Center (FQHC) 1557270139 Practice locations: Oak Park, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508287673. Details of each certification follow.

Federally qualified health center certification: CCN 781824

Legal name
PCC COMMUNITY WELLNESS CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 23, 2014
Last certification
Jul 23, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
1 Erie CT
Ste 7120
Oak Park, IL 60302-2510

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 16

National Provider Directory

National Provider Directory
Tax ID family
PCC Community Wellness Ctr21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Sonia Taylor Individual W-2 Managing EmployeeSenior Director of Finance Jan 28, 2024
Alyssa Sianghio Individual Corporate OfficerPresident and Ceo Apr 10, 2024 100%
W-2 Managing Employee Apr 10, 2024 100%
John McDonnell Individual Corporate DirectorBoard Member Aug 26, 2011
Patricia Ford Individual Corporate DirectorBoard Member Aug 25, 2009
Richard Ducatenzeller Individual Corporate DirectorBoard Member Jul 1, 2024
Christopher Barracks Individual Corporate DirectorBoard Member Jan 1, 2024
Ron Austin Individual Corporate DirectorBoard Chairperson Jun 8, 2001
Nilsa Campos Individual Corporate OfficerChief Operations Officer Sep 1, 2021 100%
W-2 Managing Employee Sep 1, 2021 100%
Velda Brunner Individual Corporate DirectorBoard Member Nov 29, 2015
Hiren Patel Individual Corporate OfficerChief Financial Officer Sep 11, 2024 100%
W-2 Managing Employee Sep 11, 2024 100%
Janet Y Forbes Individual Corporate DirectorBoard Member Oct 25, 2022
Wrenetha Julion Individual Corporate DirectorBoard Member Jun 30, 2020
Sara Hogue Individual Corporate OfficerChief Quality Improvement Officer Nov 4, 2019 100%
W-2 Managing Employee Nov 4, 2019 100%
Melissa Kirk Individual Corporate Director Aug 1, 2024
Paul Luning Individual Corporate OfficerChief Medical Officer Sep 17, 2007 100%
W-2 Managing EmployeeChief Medical Officer Sep 17, 2007 100%
Kenneth M Blair Individual Corporate DirectorBoard Treasurer Jul 31, 1992

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
PCC Dr Tong Health CenterOak Park, IL, CCN 141034 Federally qualified health center Other (100%) Sep 15, 2004
PCC Walk-in Wellness Center at West Suburban Medical CenterOak Park, IL, CCN 781802 Federally qualified health center Other (100%) Sep 15, 2004

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767916800000",
    "number": "1508287673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 LAKE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022606",
            "telephone_number": "708-383-0113",
            "fax_number": "708-383-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ERIE CT STE 7120",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022510",
            "telephone_number": "773-537-0020",
            "fax_number": "773-537-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCC COMMUNITY WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-17",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PCC Community Wellness Center at Loretto Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PCC Community Wellness Center at West Suburban",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.