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General NPI Number Information
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NPI Number | 1265806947
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Entity Type | Individual
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Provider Name | VICTOR ALVAREZ SR. M.A.
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Gender | Male
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Dates
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Enumeration Date | 11/18/2015
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Last Update Date | 11/18/2015
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Provider Practice Location Address
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Address Line | 1400 S AUSTIN BLVD
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City | CICERO
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State | IL
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Zip | 60804-1003
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Country | US
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Telephone | 708-329-4029
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Fax | 708-222-1495
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Provider Business Mailing Address
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Address Line | 353 WILDFLOWER WAY
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City | BOLINGBROOK
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State | IL
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Zip | 60440-4965
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Country | US
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Telephone | 804-909-4428
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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