Organization
PRIMECARE COMMUNITY HEALTH, INC.
Active
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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