NPIMap

Organization Active NPI

PCC Community Wellness Center

Doing business as PCC Community Wellness Center at Thresholds

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
National Provider Identifier
1982599346
Registry record updated Jun 9, 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 Community Wellness Center at Thresholds
Practice address
5801 W Corcoran PL
Chicago, IL 60644-1854
Phone
(773) 285-6400
Fax
(877) 669-0519
NPI assigned
Jun 9, 2025
Last updated
Jun 9, 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 Jun 9, 2025

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

5801 W Corcoran PL
Chicago, IL 60644-1854

Mailing address

5801 W Corcoran PL
Chicago, IL 60644-1854
Phone (773) 285-6400

Other names 1

  • PCC COMMUNITY WELLNESS CENTER AT THRESHOLDS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251008001782 IL Part A Provider - Federally Qualified Health Center (FQHC) 1557270139 Practice locations: Chicago, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982599346. Details of each certification follow.

Federally qualified health center certification: CCN C41050

Legal name
PCC COMMUNITY WELLNESS CENTER
Doing business as
PCC COMMUNITY WELLNESS CENTER AT THRESHOLDS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 11, 2025
Last certification
Sep 11, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
5801 W Corcoran PL
Chicago, IL 60644

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
Part of
PCC Community Wellness Ctr

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 DirectorSecretary 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 DirectorVice Chairperson Jun 30, 2020
Sara Hogue Individual Corporate OfficerChief Quality Improvement Officer Jan 1, 2020 100%
W-2 Managing Employee Jan 1, 2020 100%
Melissa Kirk Individual Corporate DirectorBoard Member Jul 1, 2024
Paul Luning Individual Corporate OfficerChief Medical Officer Sep 17, 2007 100%
W-2 Managing Employee Sep 17, 2007 100%
Kenneth M Blair Individual Corporate DirectorTreasurer 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": "1749427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1982599346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 W CORCORAN PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606441854",
            "telephone_number": "773-285-6400",
            "fax_number": "877-669-0519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 W CORCORAN PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606441854",
            "telephone_number": "773-285-6400",
            "fax_number": "877-669-0519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCC COMMUNITY WELLNESS CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PCC COMMUNITY WELLNESS CENTER",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-05-23",
        "status": "A",
        "authorized_official_last_name": "SIANGHIO",
        "authorized_official_first_name": "ALYSSA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO & PRESIDENT",
        "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": [],
    "other_names": [
        {
            "organization_name": "PCC COMMUNITY WELLNESS CENTER AT THRESHOLDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.