| NPI | 1073536991 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2006-07-25 |
| Last Updated | 2026-01-09 |
| Authorized Official | Alyssa Sianghio President and CEO Phone: 7083839786 |
| Mailing Address | 14 W Lake St Oak Park, IL 60302-2606 United States Phone: (708) 383-0113 | Fax: (708) 383-1378 📍 View Map |
| Primary Practice Address | 14 W Lake St Oak Park, IL 60302-2606 United States Phone: (708) 383-0113 | Fax: (708) 383-9911 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | — | 141888 | Medicare Part A Provider Number |
| MEDICAID | IL | ========= | — |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 261QF0400X – Clinic/Center, Federally Qualified Health Center (FQHC) | IL | 001 |
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About NPI 1073536991
Pcc Community Wellness Center is an organization registered in the CMS NPPES NPI Registry with NPI number 1073536991. The primary specialty listed is Clinic/Center, Federally Qualified Health Center (FQHC). The organization is located in Oak Park, IL. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-07-25. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1073536991?
NPI 1073536991 belongs to Pcc Community Wellness Center, a Clinic/Center, Federally Qualified Health Center (FQHC) in Oak Park, IL. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1073536991 active?
The current status of NPI 1073536991 in the NPPES registry is Active. The record was last updated on 2026-01-09.
What specialty is NPI 1073536991?
NPI 1073536991 is classified under the taxonomy Clinic/Center, Federally Qualified Health Center (FQHC). Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1073536991?
You can verify NPI 1073536991 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1073536991?
The primary practice address on file for NPI 1073536991 is 14 W Lake St, Oak Park, IL 60302-2606. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1073536991 issued?
NPI 1073536991 was first issued (enumerated) on 2006-07-25. The NPPES record was last updated on 2026-01-09.
Practice Location Map
Pcc Community Wellness Center is located at 14 W Lake St, Oak Park, IL. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Pcc Community Wellness Center. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1073536991. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Clinic/Center, Federally Qualified Health Center (FQHC) | 001 | IL |