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LEGACY MEDICAL CARE INC
NPI 1003365412
Clinic/Center - Federally Qualified Health Center (FQHC) in East Dundee, IL

Active since September 26, 2016CLIA Certified · 2 labs
519 DUNDEE AVE, EAST DUNDEE, IL 60118(847) 749-2248 Get Directions Write a Review

NPPES record last updated: May 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 13, 2026, Sep 26, 2016 (2 updates tracked since 2016).

About Legacy Medical Care Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEGACY MEDICAL CARE INC (NPI 1003365412) is a healthcare organization registered as a federally qualified health center (fqhc) in East Dundee, Illinois and active in the NPI registry since September 2016. The organization holds 2 active CLIA laboratory certificates and lists Melissa Donorio, Ceo, as its authorized official.

NPPES Registry Identity

NPI1003365412
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameLEGACY MEDICAL CARE INC
Location Address519 DUNDEE AVEEast Dundee, IL 60118-1642
Mailing Address151 Dundee Ave Ste CEast Dundee, IL 60118-1649 · (847) 844-3274 · Fax (847) 844-3275
Phone(847) 749-2248
Organization SubpartNo
Authorized OfficialMelissa DonorioCeo · (847) 749-2248
Enumeration DateSeptember 26, 2016
Last NPPES UpdateMay 13, 20262 updates tracked since enumeration
NPPES CertifiedMay 13, 2026
✔ NPI 1003365412 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
519 DUNDEE AVE, East Dundee, IL 60118
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CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2026196

Legacy Medical Care Inc - East Dundee · East Dundee, IL
Active · expires Jun 26, 2027
CLIA Number14D2026196
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateJune 27, 2025
Certificate Expiration DateJune 26, 2027
Laboratory DirectorPanita Chiemmongkoltip MD
Laboratory Phone(847) 844-3274
Laboratory LocationLegacy Medical Care Inc - East Dundee151C Dundee Rd, East Dundee, IL 60118
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 14D2123032

Legacy Medical Care Inc · Hanover Park, IL
Active · expires Dec 11, 2026
CLIA Number14D2123032
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateDecember 12, 2024
Certificate Expiration DateDecember 11, 2026
Laboratory DirectorErnest G. Nora MD
Laboratory Phone(847) 749-2248
Laboratory LocationLegacy Medical Care Inc6620 N Barrington Rd, Hanover Park, IL 60133
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Legacy Medical Care Inc's NPI number?

The NPI number for Legacy Medical Care Inc is 1003365412. It was assigned to this organization in the NPPES registry on September 26, 2016.

Where is Legacy Medical Care Inc located?

Legacy Medical Care Inc is located at 519 Dundee Ave, East Dundee, IL 60118. The listed phone number is (847) 749-2248.

What is Legacy Medical Care Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Legacy Medical Care Inc hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Legacy Medical Care Inc was last updated on May 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.