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NPI Code Detail

MEDICARE: ALIVIO MEDICAL CENTER, INC.

MEDICARE: ALIVIO MEDICAL CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center
2261QM1300XMulti-Specialty Clinic/Center
3261QF0400XFederally Qualified Health Center (FQHC)

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2920890OTHERILMEDICARE PART B GROUP NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10001618612OTHERILBCBS

General Provider Information

NPI Number : 1073617387
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALIVIO MEDICAL CENTER, INC.
Provider Business Mailing Address
First Line : 966 W 21ST ST
Second Line :
City : CHICAGO
State : IL
Zip : 60608-4511
Country : US
Telephone Number : 773-254-1400
Fax Number : 312-829-6843
Provider Business Practice Location Address
First Line : 966 W. 21ST STREET
Second Line :
City : CHICAGO
State : IL
Zip : 60608-4511
Country : US
Telephone Number : 773-254-1400
Fax Number : 312-829-6842
Authorized Official
Title or Position : CEO
Name : MRS. ESTHER CORPUZ
Credential :
Telephone Number : 312-829-6304
Provider Enumeration Date : 09/08/2006
Last Update Date : 04/22/2026

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Directions to “ALIVIO MEDICAL CENTER, INC. ” Practice Location

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