Healthcare Provider Details

I. General information

NPI: 1275767394
Provider Name (Legal Business Name): DAVID VINCENT ALVAREZ DNP, APN-CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2009
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 N. PULASKI RD BUILDING C -- 2ND FLOOR
CHICAGO IL
60646
US

IV. Provider business mailing address

4725 N SHERIDAN RD UNIT 2C
CHICAGO IL
60640-7041
US

V. Phone/Fax

Practice location:
  • Phone: 773-484-3445
  • Fax: 312-744-8442
Mailing address:
  • Phone: 773-484-8183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209007568
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041282033
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number277000006
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: