Organization
ALIVIO MEDICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ESTHER CORPUZ CEO (CHIEF EXECUTIVE OFFICER)
(312) 829-6304
Entity
Organization
Contact information
Practice address
966 W 21ST ST, CHICAGO, IL 60608-4511
(773) 254-1400
Mailing address
966 W 21ST ST, CHICAGO, IL 60608-4511
(773) 254-1400
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
10/12/2021
Last updated
12/03/2021
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