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Individual

MANUEL E. ALVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6832 OGDEN AVE, BERWYN, IL 60402-3643
(708) 795-0890
(708) 795-1521
Mailing address
5625 BENTLEY AVE, CLARENDON HILLS, IL 60514-1509
(630) 325-2655
(630) 325-2993

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036085880
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036085880
IL
01
12259
AMERIGROUP
IL
01
2232097
BLUE CROSS BLUE SHIELD
IL
01
P00472782
RAILROAD MEDICARE
IL
Enumeration date
11/20/2006
Last updated
09/21/2023
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