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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