Organization
ALIVIO MEDICAL CENTER, INC.
Active
Other names
Alivio Medical Center at Benito Juarez Community Academy
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA RENEE WRIGHT (CREDENTIALING SPECIALIST)
(773) 650-1230
Entity
Organization
Contact information
Practice address
1450-1510 W. CERMAK ROAD, CHICAGO, IL 60608
(773) 254-1400
Mailing address
966 W 21ST ST, CHICAGO, IL 60608-4511
(773) 254-1400
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
IL
Enumeration date
08/21/2018
Last updated
08/21/2018
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