NPIMap

Organization Active NPI

Alivio Medical Center, Inc.

  • Multi-Specialty Clinic/Center
  • Chicago, IL
National Provider Identifier
1083860845
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ALIVIO MEDICAL CENTER, INC.
Practice address
Alivio Medical Ctr
75 Remittance Dr. Suite 6577
Chicago, IL 60675-6577
Phone
(312) 829-6327
Fax
(312) 829-6843
NPI assigned
Aug 13, 2008
Last updated
Jul 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Local Education Agency (LEA) 251300000X NU

Addresses

Primary practice location

Alivio Medical Ctr
75 Remittance Dr. Suite 6577
Chicago, IL 60675-6577

Mailing address

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

Other identifiers 6

IdentifierTypeStateIssuer
036113015 3MedicaidIL
920890OtherILMEDICARE PART B TPAN
141077OtherILTPAN
0001618612OtherILBCBS
036100871 3MedicaidIL
036118630 1MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081114000791 IL Part B Supplier - Clinic/Group Practice 5698840924 Receives reassigned benefits from 39 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the 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 1

The Medicare certification numbers (CCNs) connected to NPI 1083860845. Details of each certification follow.

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 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

Locations

1450 W Cermak Rd
#1510
Chicago, IL 60608
Phone (773) 254-1400

2355 S Western Ave
Chicago, IL 60608
Phone (773) 254-1400

4255 W 63rd St
Chicago, IL 60629
Phone (773) 306-0981

75 Remittance Dr
Dept 6577
Chicago, IL 60675
Phone (312) 829-6327

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 OfficerCfo Jan 16, 2024
Alejandra Perez-Tamayo Individual Corporate DirectorBoard Member Jun 1, 2018
Esther Corpuz Individual Corporate OfficerCeo Feb 11, 2014
Mahamid Khan Individual W-2 Managing EmployeeDental Director Jun 15, 2020
Maria Granados Individual Corporate OfficerHR Director Jun 18, 2002
Jennifer Vargas Individual Corporate OfficerChief Medical Officer Jun 1, 2008
Teresa Fraga Individual Corporate DirectorBoard President Jan 1, 2007
Antonio Guillen Individual 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 38

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 38

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783641600000",
    "number": "1083860845",
    "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": "ALIVIO MEDICAL CTR",
            "address_2": "75 REMITTANCE DR. SUITE 6577",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606756577",
            "telephone_number": "312-829-6327",
            "fax_number": "312-829-6843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALIVIO MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-13",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036113015 3",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B TPAN",
            "identifier": "920890",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TPAN",
            "identifier": "141077",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0001618612",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100871 3",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036118630 1",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.