Organization
ALIVIO MEDICAL CENTER, INC
Active
Other names
Alivio Medical Center at John Spry Community School
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ESTHER CORPUZ (CEO)
(312) 829-6304
Entity
Organization
Contact information
Practice address
2400 S. MARSHALL BLVD, CHICAGO, IL 60623-4146
(773) 254-1400
Mailing address
966 W. 21ST STREET, CHICAGO, IL 60608-4511
(773) 254-1400
(312) 829-6673
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
—
IL
261QC1500X
Community Health Clinic/Center
—
IL
261QS1000X
Student Health Clinic/Center
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141077
TPAN MORGAN
IL
01
—
141854
TPAN
IL
01
—
1618612
BCBS
IL
Enumeration date
12/15/2008
Last updated
08/19/2014
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