| Alivio Medical Center Inc | |
|
6447 Cermak Rd Berwyn IL 60402-2311 | |
| (312) 829-6870 | |
| (312) 829-6375 |
| Full Name | Alivio Medical Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6447 Cermak Rd, Berwyn, Illinois |
| Authorized Official Name and Position | Esther Corpuz (CEO) |
| Authorized Official Contact | 3128296304 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alivio Medical Center Inc 966 W. 21st Street Chicago IL 60608-4511 Ph: (773) 254-1400 | Alivio Medical Center Inc 6447 Cermak Rd Berwyn IL 60402-2311 Ph: (312) 829-6870 |
| NPI Number | 1255646857 |
|---|---|
| Provider Enumeration Date | 08/09/2010 |
| Last Update Date | 08/18/2014 |
| Medicare PECOS PAC ID | 5698840924 |
|---|---|
| Medicare Enrollment ID | O20180124003382 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255646857 | NPI | - | NPPES |
| 0001618612 | Other | BCBS | |
| 036113015 3 | Medicaid | IL | |
| 141077 | Other | IL | MEDICARE TPAN NUMBER |
| 920890 | Other | IL | MEDICARE TPAN |
| 141854 | Other | IL | MEDICARE TPAN NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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