PCC Community Wellness Center

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

PCC COMMUNITY WELLNESS CENTER

Doing business as

PCC Walk-In Wellness Center

Practice address

1044 N Francisco Ave
Chicago, IL 60622-2743

Phone

(773) 292-8216

NPI assigned

Aug 6, 2009

Last updated

Aug 6, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

PCC COMMUNITY WELLNESS CENTERAs reported in NPPES

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

Authorized official

Name

Robert J Urso

Title

President and Ceo

Phone

(708) 383-9786

Specialties & licenses 1

Addresses

Other names 1

• PCC Walk-In Wellness Center Doing business as

Part of

PCC Community Wellness Ctr

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249516800000",
    "number": "1962633081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 N FRANCISCO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 N FRANCISCO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222743",
            "telephone_number": "773-292-8216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCC COMMUNITY WELLNESS CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PCC COMMUNITY WELLNESS CENTER",
        "enumeration_date": "2009-08-06",
        "last_updated": "2009-08-06",
        "status": "A",
        "authorized_official_last_name": "URSO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "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 Walk-In Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• PCC Community Wellness Center (PCC Austin Family Health Center)
• PCC Community Wellness Center (PCC Collaborative Bridges Health Center)
• PCC Community Wellness Center (PCC Walk-In Wellness)
• PCC Community Wellness Center (PCC Diabetes Prevention Program)
• PCC Community Wellness Center (Interfaith House)
• PCC Community Wellness Center (PCC Community Wellness Center at Thresholds)
• Pdssc-Chicago, Inc.
• Jason Pe, MD
• John Peabody
• Michael Peabody, MD

• Federally Qualified Health Center (FQHC) in Chicago, IL
• Providers in Chicago, 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 Aug 6, 2009; 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.