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Organization

PCC COMMUNITY WELLNESS CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT J URSO (PRESIDENT CEO)
(708) 383-9786
Entity
Organization

Contact information

Practice address
14 LAKE ST, OAK PARK, IL 60302-2606
(708) 383-0113
(708) 383-1378
Mailing address
14 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

Other

Enumeration date
07/25/2006
Last updated
08/22/2020
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