Provider Demographics
NPI:1336114818
Name:ALVARADO, JANET L (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:L
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 POPLAR STREET
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IL
Mailing Address - Zip Code:62249-1677
Mailing Address - Country:US
Mailing Address - Phone:618-654-7578
Mailing Address - Fax:618-654-1703
Practice Address - Street 1:821 POPLAR STREET
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IL
Practice Address - Zip Code:62249-1677
Practice Address - Country:US
Practice Address - Phone:618-654-7578
Practice Address - Fax:618-654-1703
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0036-087968207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL224413OtherHEALTHLINK
IL4408OtherGROUP HEALTH PLAN
IL10637693OtherCAQH
ILPC16015OtherCIGNA
IL0400952OtherUHC
IL2414373OtherAETNA
IL06021399OtherBCBS
IL2414373OtherAETNA
IL10637693OtherCAQH