NPI: 1104375518 · MOUNT PROSPECT, IL 60056 · Federally Qualified Health Center (FQHC) · NPI assigned 09/26/2016
| Authorized Official | DONORIO, MELISSA (CEO) |
| NPI Enumeration Date | 09/26/2016 |
Other providers sharing the same authorized official: DONORIO, MELISSA
| Provider | City | State | Total Paid |
|---|---|---|---|
| LEGACY MEDICAL CARE INC | ADDISON | IL | $1.72M |
| LEGACY MEDICAL CARE INC | HANOVER PARK | IL | $1.67M |
| LEGACY MEDICAL CARE INC | EAST DUNDEE | IL | $1.55M |
| LEGACY MEDICAL CARE INC | WEST CHICAGO | IL | $7K |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 18 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 18 | 15 | $3K |