Organization
ALIVIO MEDICAL CENTER
Active
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 ST, CHICAGO, IL 60608-4511
(773) 254-1400
(312) 829-6673
Mailing address
966 W 21ST ST, CHICAGO, IL 60608-4511
(773) 254-1400
(312) 829-6673
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
1138738
IL
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
1138738
IL
Other
Enumeration date
05/13/2009
Last updated
08/19/2014
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