Organization
PRIMECARE COMMUNITY HEALTH, INC.
Active
Other names
PrimeCare Fullerton
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH MOLDOVAN (CHIEF FINANCIAL OFFICER)
(312) 491-5034
Entity
Organization
Contact information
Practice address
3924 W FULLERTON AVE, CHICAGO, IL 60647-2228
(773) 276-2229
(773) 276-2190
Mailing address
1431 N. WESTERN AVE., SUITE #401, CHICAGO, IL 60622-1797
(312) 633-5841
(312) 491-5485
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
01/25/2007
Last updated
10/26/2017
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