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CH05662M ALIVIO MEDICAL CENTER, INC (Active)
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Main Details
Name
ALIVIO MEDICAL CENTER, INC
Subdivision Name
AMC Mobile Unit
Type
HRSA-Funded Health Center
Site ID
BPS-H80-019738
340B ID
CH05662M
Grant Number
H80CS00116
Additional Details
Current Program Status
Active
Registration Date
10/13/2022
Participating Start Date
1/1/2023
Participating Approval Date
11/2/2022
Last Recertification Date
2/28/2025
Contacts
Authorizing Official
Alivio Medical Center
Ankit Prakash Patel, CFO
(312) 312-2719
Primary Contact
Alivio Medical Center
ESTHER CORPUZ, CHIEF EXECUTIVE OFFICER
(312) 829-6304
Addresses
Street Address
966 W 21st St
Chicago, IL 60608-4511
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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