MEDICARE: ALEJANDRO CLAVIER

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	208000000X	Pediatrics Physician	036107443	IL

General Provider Information

NPI Number	:	1083623425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRO CLAVIER

Provider Business Mailing Address
First Line	:	3124 W 59TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60629-2504
Country	:	US
Telephone Number	:	773-906-5160
Fax Number	:	773-498-7415

Provider Business Practice Location Address
First Line	:	3124 W 59TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60629-2504
Country	:	US
Telephone Number	:	773-906-5160
Fax Number	:	773-498-7415

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

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	05/13/2015

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Directions to “ ALEJANDRO CLAVIER ” Practice Location

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