Organization
MEDICOR PARTNERS, S.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL E ALVA MD (PHYSICIAN)
(630) 325-2655
Entity
Organization
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
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036085880
IL
207RI0200X
Infectious Disease Physician
036090919
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
#DH1149
RAILROAD MEDICARE
IL
Enumeration date
05/16/2007
Last updated
09/21/2023
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