PRIMECARE COMMUNITY HEALTH, INC. – Federally Qualified Health Center (FQHC), NPI 1225010911

PRIMECARE COMMUNITY HEALTH, INC. is a healthcare provider. based in Chicago, Illinois. specializing in Federally Qualified Health Center (FQHC). The NPI Number for PRIMECARE COMMUNITY HEALTH, INC. is 1225010911

Main info

Organization
Name
PRIMECARE COMMUNITY HEALTH, INC.
NPI
1225010911
Phone
(312) 633-5841
Address
2232 N CLYBOURN AVE FL 3
Authorized Official
JOSEPH MOLDOVAN CHIEF FINANCIAL OFFICER
Enumeration Date
17 November 2005
Last Update Date
26 October 2017
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:20State licenses:0Digital endpointsOther names

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Provider Addresses for PRIMECARE COMMUNITY HEALTH, INC.

  • North Clybourn Avenue, Cabrini-Green, Chicago River North, Chicago, Cook County, Illinois, 60610, United States

    CHICAGO, IL 606143193

    Phone: (312) 633-5841

    Fax: (773) 269-5500

    Type: Mailing

  • Western Avenue, 420, North Artesian Avenue, Ukrainian Village, West Town, Chicago, Cook County, Illinois, 60612, United States

    STE 406

    CHICAGO, IL 606221797

    Phone: (312) 633-5841

    Fax: (312) 491-5020

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-01-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20070111000408OFederally Qualified Health Center (Fqhc)ILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60614)

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Reviews

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Frequently asked questions

Does PRIMECARE COMMUNITY HEALTH, INC. share an NPI with anyone else?
NPI numbers are unique to each provider or organization — PRIMECARE COMMUNITY HEALTH, INC. uses 1225010911.
Does the file indicate PRIMECARE COMMUNITY HEALTH, INC. is practicing under active NPI?
Directory data currently reports PRIMECARE COMMUNITY HEALTH, INC. as active.
What is PRIMECARE COMMUNITY HEALTH, INC. best known for clinically?
Directory data describes PRIMECARE COMMUNITY HEALTH, INC. with Federally Qualified Health Center (FQHC). Clinical services aligned with this taxonomy classification.
What address line appears for PRIMECARE COMMUNITY HEALTH, INC.?
PRIMECARE COMMUNITY HEALTH, INC.'s geographic hint is Chicago, Illinois in our summary view.
What does 'Organization' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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