Organization
PRIMECARE COMMUNITY HEALTH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT VANGILDER (CFO)
(314) 800-6161
Entity
Organization
Contact information
Practice address
1431 N WESTERN AVE STE 202, CHICAGO, IL 60622-7712
(773) 276-2272
Mailing address
1431 N WESTERN AVE STE 406, CHICAGO, IL 60622-1774
(312) 633-5841
(312) 491-5020
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
06/04/2020
Last updated
11/18/2022
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