| Pcc West Town Family Health Center | |
|
2434 W Division St Chicago IL 60622-2942 | |
| (773) 292-8300 | |
| (708) 292-2601 |
| Full Name | Pcc West Town Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2434 W Division St, Chicago, Illinois |
| Authorized Official Name and Position | Robert J Urso (PRESIDENT - CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7083839786 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pcc West Town Family Health Center 2434 W Division St Chicago IL 60622-2942 Ph: (773) 292-8300 | Pcc West Town Family Health Center 2434 W Division St Chicago IL 60622-2942 Ph: (773) 292-8300 |
| NPI Number | 1164628012 |
|---|---|
| Provider Enumeration Date | 06/26/2007 |
| Last Update Date | 03/05/2021 |
| Medicare PECOS PAC ID | 1557270139 |
|---|---|
| Medicare Enrollment ID | O20081120000723 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164628012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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