NPIMap

Organization Active NPI

Alivio Medical Center, Inc.

Doing business as Alivio Medical Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
National Provider Identifier
1073617387
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ALIVIO MEDICAL CENTER, INC.
Doing business as
Alivio Medical Center
Practice address
966 W. 21St Street
Chicago, IL 60608-4511
Phone
(773) 254-1400
Fax
(312) 829-6842
NPI assigned
Sep 8, 2006
Last updated
Apr 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Esther Corpuz
Title
Ceo
Phone
(312) 829-6304

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

966 W. 21St Street
Chicago, IL 60608-4511

Mailing address

966 W 21St St
Chicago, IL 60608-4511
Phone (773) 254-1400

Other identifiers 2

IdentifierTypeStateIssuer
920890OtherILMEDICARE PART B GROUP NUMBER
0001618612OtherILBCBS

Other names 1

  • Alivio Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20080820000457 IL Part A Provider - Federally Qualified Health Center (FQHC) 5698840924 Practice locations: Chicago, IL
O20081114000791 IL Part B Supplier - Clinic/Group Practice 5698840924 Receives reassigned benefits from 39 practitioners
9 other NPIs on this enrollment
Practice locations: Berwyn, IL; Chicago, IL
O20100901000250 IL Part A Provider - Federally Qualified Health Center (FQHC) 5698840924 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chicago, IL

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1073617387. Details of each certification follow.

Federally qualified health center certification: CCN 141077

Legal name
ALIVIO MEDICAL CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 17, 2008
Last certification
Sep 17, 2008
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jul 30, 1991 in IL
Enrollment address
966 W 21St St
Chicago, IL 60608-4511

Federally qualified health center certification: CCN 141854

Legal name
ALIVIO MEDICAL CENTER, INC.
Doing business as
ALIVIO MEDICAL CENTER AT WESTERN
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 1, 1993
Last certification
Mar 1, 1993
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 30, 1991 in IL
Enrollment address
2355 S Western Ave
Chicago, IL 60608-3837

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Peter Martinez Individual Corporate DirectorVice President Jan 1, 1989
Ankit Patel Individual Corporate OfficerChief Financial Officer Jan 16, 2024
Corporate OfficerCfo Jan 16, 2024
Alejandra Perez-Tamayo Individual Corporate DirectorBoard Member Jun 1, 2025
Corporate DirectorBoard Member Jun 1, 2018
Esther Corpuz Individual Corporate OfficerCeo Feb 11, 2014
Mahamid Khan Individual Corporate OfficerDental Director Jun 15, 2020
W-2 Managing EmployeeDental Director Jun 15, 2020
Maria Granados Individual W-2 Managing EmployeeHR Director Jun 18, 2002
Corporate OfficerHR Director Jun 18, 2002
Jennifer Vargas Individual Corporate OfficerChief Medical Officer Jun 1, 2008
Teresa Fraga Individual Corporate DirectorPresident Jun 1, 2005
Corporate DirectorBoard President Jan 1, 2007
Antonio Guillen Individual Corporate DirectorTreasurer Jun 1, 2018
Corporate DirectorTreasurer Jun 1, 2022
Jill Seidman Individual Corporate DirectorBoard Member Jun 1, 2016

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 42

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 42

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776816000000",
    "number": "1073617387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 W 21ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606084511",
            "telephone_number": "773-254-1400",
            "fax_number": "312-829-6843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 W. 21ST STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606084511",
            "telephone_number": "773-254-1400",
            "fax_number": "312-829-6842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALIVIO MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-08",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A",
        "authorized_official_last_name": "CORPUZ",
        "authorized_official_first_name": "ESTHER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "312-829-6304",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B GROUP NUMBER",
            "identifier": "920890",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0001618612",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alivio Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alivio Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.