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General NPI Number Information
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NPI Number | 1255405452
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Entity Type | Individual
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Provider Name | MANUEL E. ALVA M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 6832 OGDEN AVE
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City | BERWYN
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State | IL
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Zip | 60402-3643
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Country | US
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Telephone | 708-795-0890
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Fax | 708-795-1521
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Provider Business Mailing Address
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Address Line | 5625 BENTLEY AVE
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City | CLARENDON HILLS
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State | IL
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Zip | 60514-1509
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Country | US
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Telephone | 630-325-2655
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Fax | 630-325-2993
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 036085880
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License Number State | IL
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