Puerto Rican Cultural Center

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

2015 Issued in IL

Legal business name

PUERTO RICAN CULTURAL CENTER

Practice address

2640 W Division St
Chicago, IL 60622-2850

Phone

(773) 278-6737

Fax

(773) 278-6753

NPI assigned

May 14, 2015

Last updated

May 14, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jorge Cestou, MBA

Title

Director, Programs and Services VS

Phone

(773) 278-6737

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1629456363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222850",
            "telephone_number": "773-278-6737",
            "fax_number": "773-278-6753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222850",
            "telephone_number": "773-278-6737",
            "fax_number": "773-278-6753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUERTO RICAN CULTURAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "CESTOU",
        "authorized_official_first_name": "JORGE",
        "authorized_official_title_or_position": "DIRECTOR, PROGRAMS AND SERVICES VS",
        "authorized_official_telephone_number": "773-278-6737",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "IL",
            "license": "2015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA WAIVER",
            "identifier": "14D1023971",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ami L Puente, COTA
• Puentes Bilingual Speech and Language Therapy LLC
• Mariana Beatriz Puentes, LCSW
• John William Pueringer, DO, MHA, MS
• Nicole G Puertas Sanchez
• Helen Puesta, COTA/L
• Nikola K Puffinbarger, MD
• Stephanie Nicole Puga-Bernaldo, MD
• Cheryl Lynn Pugh, PSY.D.
• Courtney Simone Pugh, MD

• Community Health Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Community Health Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.