Healthcare Provider Details

I. General information

NPI: 1467001057
Provider Name (Legal Business Name): VICTORIA ALVAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2019
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 N COUNTY FARM RD
WHEATON IL
60187-3977
US

IV. Provider business mailing address

115 N COUNTY FARM RD
WHEATON IL
60187-3977
US

V. Phone/Fax

Practice location:
  • Phone: 630-627-1700
  • Fax:
Mailing address:
  • Phone: 630-627-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149023909
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: