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Organization
ALIVIO MEDICAL CENTER-JUAREZ HIGH SCHOOL
Active
Organization
ALIVIO MEDICAL CENTER-JUAREZ HIGH SCHOOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ESTHER CORPUZ C.E.O. (CHIEF EXECUTIVE OFFICER)
(312) 829-6304
Entity
Organization
Contact information
Practice address
1450 W CERMAK RD, CHICAGO, IL 60608-4408
(773) 254-1400
(312) 733-3563
Mailing address
2355 S WESTERN AVE, CHICAGO, IL 60608-3837
(773) 254-1400
(312) 733-3563
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
771115088
IL
207R00000X
Internal Medicine Physician
771115008
IL
208000000X
Pediatrics Physician
Primary
771115088
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
IL
Enumeration date
03/18/2015
Last updated
03/18/2015
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