PCC WEST TOWN FAMILY HEALTH CENTER
NPI 1164628012
Clinic/Center - Federally Qualified Health Center (FQHC) in Chicago, IL

Q: What is Pcc Community Wellness Center's NPI number?

The NPI number for Pcc Community Wellness Center is 1164628012. It was assigned to this organization in the NPPES registry on June 26, 2007. The provider is doing business as Pcc West Town Family Health Center.

Q: What is Pcc Community Wellness Center's specialty?

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

Active since June 26, 2007CLIA 14D1079152 · Microscopy

2434 W DIVISION ST, CHICAGO, IL 60622(773) 292-8300(708) 292-2601 Get Directions Write a Review

NPPES record last updated: March 5, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Pcc West Town Family Health Center NPPES

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

PCC WEST TOWN FAMILY HEALTH CENTER (NPI 1164628012) is a healthcare organization registered as a federally qualified health center (fqhc) in Chicago, Illinois and active in the NPI registry since June 2007. The organization holds a CLIA Microscopy certificate valid through January 7, 2027 and lists Robert J Urso, President - Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1164628012

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NamePCC COMMUNITY WELLNESS CENTER

Location Address2434 W DIVISION STChicago, IL 60622-2942

Mailing Address2434 W Division StChicago, IL 60622-2942 · (773) 292-8300 · Fax (708) 292-2601

Phone(773) 292-8300

Fax(708) 292-2601

Organization SubpartNo

Authorized OfficialRobert J UrsoPresident - Chief Executive Officer · (708) 383-9786

Enumeration DateJune 26, 2007

Last NPPES UpdateMarch 5, 2021

NPPES CertifiedMarch 5, 2021

✔ NPI 1164628012 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

2434 W DIVISION ST, Chicago, IL 60622

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Other Names 1

Doing Business AsPcc West Town Family Health Center

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

CLIA Laboratory Certificates CMS CLIA

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 for Provider-Performed Microscopy Procedures (PPMP) 14D1079152

Pcc West Town Family Health Center · Chicago, IL

Active · expires Jan 7, 2027

CLIA Number14D1079152

Laboratory TypePhysician Office

Certificate Effective DateJanuary 8, 2025

Certificate Expiration DateJanuary 7, 2027

Laboratory DirectorJacob M. Smith M D

Laboratory Phone(773) 584-4178

Laboratory LocationPcc West Town Family Health Center2434 W Division Street, Chicago, IL 60622

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MIRANDA ROBLES LSW

Social Worker (Clinical)