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NPI Code Detail

MEDICARE: MR. VICTOR ALVAREZ SR. M.A.

MEDICARE: MR. VICTOR ALVAREZ SR. M.A.
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
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1265806947
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. VICTOR ALVAREZ SR. M.A.
Provider Business Mailing Address
First Line : 353 WILDFLOWER WAY
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4965
Country : US
Telephone Number : 804-909-4428
Fax Number :
Provider Business Practice Location Address
First Line : 1400 S AUSTIN BLVD
Second Line :
City : CICERO
State : IL
Zip : 60804-1003
Country : US
Telephone Number : 708-329-4029
Fax Number : 708-222-1495
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2015
Last Update Date : 11/18/2015

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