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Organization
ALIVIO MEDICAL CENTER, INC.
Active
Organization
ALIVIO MEDICAL CENTER, INC.
Active
Other names
Alivio Medical Center Cicero
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ESTHER CORPUZ (CEO)
(312) 829-6304
Entity
Organization
Contact information
Practice address
4842 W CERMAK RD, CICERO, IL 60804-2531
(312) 829-6304
(708) 660-0349
Mailing address
966 W 21ST ST, CHICAGO, IL 60608-4511
(773) 254-1400
(312) 829-6673
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001618612
BCBS
IL
01
—
920890
MEDICARE GROUP NUMBER
IL
05
—
PENDING
—
IL
Enumeration date
08/07/2008
Last updated
08/19/2014
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