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CH057440 PCC COMMUNITY WELLNESS CENTER (Active)
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Main Details
Name
PCC COMMUNITY WELLNESS CENTER
Subdivision Name
PCC Lake Street Family Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001692
340B ID
CH057440
Grant Number
H80CS00276
Additional Details
Current Program Status
Active
Registration Date
7/1/1997
Participating Start Date
7/1/1997
Participating Approval Date
9/15/2003
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
PCC Community Wellness Center
Alyssa Sianghio, Chief Executive Officer
(708) 383-1113
Primary Contact
PCC Community Wellness Center
Sonia Taylor, Senior Director, Finance
(708) 262-0038
Addresses
Street Address
14 Lake St
Oak Park, IL 60302-2606
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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