Organization
ALIVIO MEDICAL CENTER INC
Active
Other names
Alivio Medical Center at Jose Clemente Orozco Community Academy
Organization subpart
No
Provider details
NPI number
Authorized official
ANKIT PATEL (CFO)
(312) 312-2719
Entity
Organization
Contact information
Practice address
1940 W. 18TH STREET, CHICAGO, IL 60608-1903
(773) 254-1400
(312) 829-6375
Mailing address
966 W 21ST ST, CHICAGO, IL 60608-4511
(773) 254-1400
(312) 243-1705
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
IL
261QS1000X
Student Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001618612
BCBS
IL
01
—
141077
MEDICARE TPAN
IL
01
—
141854
MEDICARE TPAN
IL
Enumeration date
08/09/2010
Last updated
04/22/2026
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