MEDICARE: NOAH AXEL ALVARADO MSW

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
1	104100000X	Social Worker		IL
2	101YM0800X	Mental Health Counselor		IL

General Provider Information

NPI Number	:	1649916370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOAH AXEL ALVARADO MSW

Provider Business Mailing Address
First Line	:	2527 N FAIRFIELD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-1807
Country	:	US
Telephone Number	:	312-720-9751
Fax Number	:

Provider Business Practice Location Address
First Line	:	4007 N BROADWAY ST STE 105
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-6075
Country	:	US
Telephone Number	:	773-304-8723
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2022
Last Update Date	:	04/21/2026

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