| Alivio Medical Center-juarez High School | |
|
1450 W Cermak Rd Chicago IL 60608-4408 | |
| (773) 254-1400 | |
| (312) 733-3563 |
| Full Name | Alivio Medical Center-juarez High School |
|---|---|
| Speciality | Pediatrics |
| Location | 1450 W Cermak Rd, Chicago, Illinois |
| Authorized Official Name and Position | Esther Corpuz (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3128296304 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alivio Medical Center-juarez High School 2355 S Western Ave Chicago IL 60608-3837 Ph: (773) 254-1400 | Alivio Medical Center-juarez High School 1450 W Cermak Rd Chicago IL 60608-4408 Ph: (773) 254-1400 |
| NPI Number | 1417341249 |
|---|---|
| Provider Enumeration Date | 03/18/2015 |
| Last Update Date | 03/18/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417341249 | NPI | - | NPPES |
| PENDING | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 771115088 (Illinois) | Secondary |
| 207R00000X | Internal Medicine | 771115008 (Illinois) | Secondary |
| 208000000X | Pediatrics | 771115088 (Illinois) | Primary |
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