Organization
ALIVIO MEDICAL CENTER, INC.
Active
Other names
Alivio Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ESTHER CORPUZ (CEO)
(312) 829-6304
Entity
Organization
Contact information
Practice address
966 W. 21ST STREET, CHICAGO, IL 60608-4511
(773) 254-1400
(312) 829-6842
Mailing address
966 W 21ST ST, CHICAGO, IL 60608-4511
(773) 254-1400
(312) 829-6843
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001618612
BCBS
IL
01
—
920890
MEDICARE PART B GROUP NUMBER
IL
Enumeration date
09/08/2006
Last updated
04/22/2026
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