Legacy Medical Care Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

LEGACY MEDICAL CARE INC

Practice address

860 Summit St Ste 241
Elgin, IL 60120-4339

Phone

(847) 749-2248

Fax

(847) 214-4912

NPI assigned

Sep 26, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Melissa D'Onorio

Title

Ceo

Phone

(847) 749-2248

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 781895

Legal name

LEGACY MEDICAL CARE INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Nov 30, 2017

Last certification

Nov 30, 2017

Ownership / control type

For profit – corporation

Facility address

860 Summit St Suites 231 and 241
Elgin, IL 60120

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Molly Elizabeth Freely, APN

  • Pediatric Nurse Practitioner
  • Arlington Heights, IL
  • NPI 1578734927
  NPD (past)

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

{
    "created_epoch": "1474848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1750830162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S WILKE RD STE 606",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600051529",
            "telephone_number": "847-749-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 SUMMIT ST STE 241",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601204339",
            "telephone_number": "847-749-2248",
            "fax_number": "847-214-4912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "860 Summit St Ste 231",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601204339",
            "country_code": "US",
            "telephone_number": "847-749-2248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEGACY MEDICAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-26",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "D'ONORIO",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "847-749-2248",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daryl L Lee, LPC
• Ji Hun Michael Lee, D.O.
• Soo Hyun Lee
• Terri L Lee
• David Michael Lefelstein, DDS
• Donald Lellish
• Merideth Lembke
• Tonkya Johnetta Lemons, REGISTERED NURSE
• Leo G. Pepa, M.D.,LTD.
• Jose Manuel Leon Bahena

• Federally Qualified Health Center (FQHC) in Elgin, IL
• Providers in Elgin, IL by specialty
• Federally Qualified Health Center (FQHC) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.