Organization
PCC COMMUNITY WELLNESS CENTER
Active
Organization
PCC COMMUNITY WELLNESS CENTER
Active
Parent organization
PCC COMMUNITY WELLNESS CENTER
Other names
PCC Community Wellness Center, PCC Lake Street Family Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PCC COMMUNITY WELLNESS CENTER
Authorized official
ALYSSA N SIANGHIO (PRESIDENT AND CEO)
(708) 383-9786
Entity
Organization
Contact information
Practice address
14 W LAKE ST, OAK PARK, IL 60302-2606
(708) 383-0113
(708) 383-9911
Mailing address
14 W LAKE ST, OAK PARK, IL 60302-2606
(708) 383-0113
(708) 383-1378
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
001
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141888
MEDICARE PART A PROVIDER NUMBER
—
Enumeration date
07/25/2006
Last updated
01/09/2026
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