Organization Active NPI

Valentinalb,S.C.

Doing business as The Alt Clinic

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1548541022
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VALENTINALB,S.C.
Doing business as
The Alt Clinic
Practice address
4727 N Clark St Ste 1N
Chicago, IL 60640-7554
Phone
(773) 334-9300
Fax
(177) 333-4930
NPI assigned
Aug 29, 2011
Last updated
Oct 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Authorized official

Name
Anna Morgan, M.D.NPI 1144410762
Title
Medical Director
Phone
(773) 334-9300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

4727 N Clark St Ste 1N
Chicago, IL 60640-7554

Mailing address

4727 N Clark St Ste 1N
Chicago, IL 60640-7554
Phone (773) 334-9300

Other identifiers 1

IdentifierTypeStateIssuer
036122848MedicaidIL

Other names 1

  • The Alt Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110922000692 IL Part B Supplier - Clinic/Group Practice 6204007271 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2030576Alt Clinic, the (D/B/a)4727 N Clark St, Ste #1N, Chicago, IL 60640Certificate of waiverSep 29, 2027

National Provider Directory

National Provider Directory

Locations

4727 N Clark St
Ste 1N
Chicago, IL 60640
Phone (773) 334-9300

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1314576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1548541022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4727 N CLARK ST STE 1N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407554",
            "telephone_number": "773-334-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4727 N CLARK ST STE 1N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407554",
            "telephone_number": "773-334-9300",
            "fax_number": "177-333-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALENTINALB,S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-29",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "773-334-9300",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036122848",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Alt Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.