NPIMap

Organization Active NPI

Alivio Medical Center Inc

  • Student Health Clinic/Center
  • Chicago, IL
National Provider Identifier
1770739591
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
ALIVIO MEDICAL CENTER INC
Practice address
3120 S Kostner Ave
Chicago, IL 60623-4842
Phone
(773) 535-4291
Fax
(312) 829-6842
NPI assigned
Aug 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Student Health Clinic/Center 261QS1000X IL Primary

Addresses

Primary practice location

3120 S Kostner Ave
Chicago, IL 60623-4842

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
0001618612OtherILBCBS

Other names 1

  • Alivio Medical Center at Little Village 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

3120 S Kostner Ave
Chicago, IL 60623
Phone (773) 254-1400

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568937600000",
    "number": "1770739591",
    "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": "773-829-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 S KOSTNER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606234842",
            "telephone_number": "773-535-4291",
            "fax_number": "312-829-6842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALIVIO MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2019-09-20",
        "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": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0001618612",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alivio Medical Center at Little Village",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alivio Medical Center at Little Village",
            "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 Sep 20, 2019; 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.