Provider Demographics
NPI:1275767394
Name:ALVAREZ, DAVID VINCENT (DNP, APN-CNP)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:VINCENT
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:DNP, APN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4725 N SHERIDAN RD
Mailing Address - Street 2:UNIT 2C
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-7041
Mailing Address - Country:US
Mailing Address - Phone:773-484-8183
Mailing Address - Fax:
Practice Address - Street 1:2900 N. LAKESHORE DRIVE
Practice Address - Street 2:BUILDING #3; SUITE 301
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-6065
Practice Address - Country:US
Practice Address - Phone:773-484-3445
Practice Address - Fax:334-212-0945
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041282033163W00000X
IL209007568363LP0808X
IL277000006363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL$$$$$$$$$001Medicaid