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ALIVIO MEDICAL CENTER INC. NPI 1861972655


NPI Information

NPI: 1861972655
Provider Name: ALIVIO MEDICAL CENTER, INC.

Other Name: ALIVIO MEDICAL CENTER AT BENITO JUAREZ COMMUNITY ACADEMY

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
1450-1510 W. CERMAK ROAD
CHICAGO, IL
ZIP 60608
Phone: (773) 254-1400
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ALIVIO MEDICAL CENTER, INC. is a federally qualified health center (fqhc) clinic center in Chicago, IL. ALIVIO MEDICAL CENTER, INC. NPI is 1861972655. The provider is registered as an organization entity type.
The provider Other Name Is Alivio Medical Center At Benito Juarez Community Academy.

The provider's business location address is:

1450-1510 W. CERMAK ROAD
CHICAGO, IL
ZIP 60608
Phone: (773) 254-1400

The provider's authorized official is Karla Renee Wright .
The authorized official title is Credentialing Specialist and has the following contact phone number (773) 650-1230.

The enumeration date for this NPI number is 8/21/2018 and was last updated on 8/21/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1PENDINGMEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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