| Tca Health Inc Nfp | |
|
13336 S Baltimore, 1st Floor Chicago IL 60633-1425 | |
| (773) 995-6300 | |
| Not Available |
| Full Name | Tca Health Inc Nfp |
|---|---|
| Speciality | Clinic/Center |
| Location | 13336 S Baltimore, 1st Floor, Chicago, Illinois |
| Authorized Official Name and Position | Veronica Clarke (CEO) |
| Authorized Official Contact | 7739951940 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tca Health Inc Nfp 13336 S Baltimore Ave Chicago IL 60633-1425 Ph: (773) 995-6300 | Tca Health Inc Nfp 13336 S Baltimore, 1st Floor Chicago IL 60633-1425 Ph: (773) 995-6300 |
| NPI Number | 1164149100 |
|---|---|
| Provider Enumeration Date | 10/20/2022 |
| Last Update Date | 03/08/2024 |
| Medicare PECOS PAC ID | 5991696643 |
|---|---|
| Medicare Enrollment ID | O20240604000077 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164149100 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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