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Organization

PCC COMMUNITY WELLNESS CENTER

Active
Other names
PCC West Town Family Health Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT J URSO (PRESIDENT - CHIEF EXECUTIVE OFFICER)
(708) 383-9786
Entity
Organization

Contact information

Practice address
2434 W DIVISION ST, CHICAGO, IL 60622-2942
(773) 292-8300
(708) 292-2601
Mailing address
2434 W DIVISION ST, CHICAGO, IL 60622-2942
(773) 292-8300
(708) 292-2601

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Enumeration date
06/26/2007
Last updated
03/05/2021
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