NPIMap

Organization Active NPI

Alivio Medical Center, Inc.

Doing business as Alivio Medical Center Cicero

  • Family Medicine Physician
  • Cicero, IL
National Provider Identifier
1124274311
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ALIVIO MEDICAL CENTER, INC.
Doing business as
Alivio Medical Center Cicero
Practice address
4842 W Cermak Rd
Cicero, IL 60804-2531
Phone
(312) 829-6304
Fax
(708) 660-0349
NPI assigned
Aug 7, 2008
Last updated
Aug 19, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IL Primary

Addresses

Primary practice location

4842 W Cermak Rd
Cicero, IL 60804-2531

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
0001618612OtherILBCBS
920890OtherILMEDICARE GROUP NUMBER
PENDINGMedicaidIL

Other names 1

  • Alivio Medical Center Cicero Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

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

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
Tax ID family
Alivio Medical Center Inc14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

6447 Cermak Rd
Berwyn, IL 60402
Phone (773) 254-1400

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

2400 S Marshall Blvd
Chicago, IL 60623
Phone (773) 254-1400

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408406400000",
    "number": "1124274311",
    "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": "312-829-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4842 W CERMAK RD",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608042531",
            "telephone_number": "312-829-6304",
            "fax_number": "708-660-0349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALIVIO MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-07",
        "last_updated": "2014-08-19",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0001618612",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "920890",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alivio Medical Center Cicero",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cicero, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.