Alivio Medical Center, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

ALIVIO MEDICAL CENTER, INC.

Practice address

966 W 21St St
Chicago, IL 60608-4511

Phone

(773) 254-1400

NPI assigned

Oct 12, 2021

Last updated

Dec 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Esther Corpuz, CEO

Title

Chief Executive Officer

Phone

(312) 829-6304

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638489600000",
    "number": "1245992767",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 W 21ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606084511",
            "telephone_number": "773-254-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2355 S Western Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606083837",
            "country_code": "US",
            "telephone_number": "773-254-1400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALIVIO MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A",
        "authorized_official_last_name": "CORPUZ",
        "authorized_official_first_name": "ESTHER",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "312-829-6304",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Federally Qualified Health Center (FQHC) in Chicago, IL
• Providers in Chicago, IL by specialty
• Federally Qualified Health Center (FQHC) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.