Provider Demographics
NPI:1518612654
Name:ALLIANCE MEDICAL PARTNERS, LLC
Entity Type:Organization
Organization Name:ALLIANCE MEDICAL PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-526-6797
Mailing Address - Street 1:1 INDIANA SQ STE 2060
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-2020
Mailing Address - Country:US
Mailing Address - Phone:800-526-6797
Mailing Address - Fax:
Practice Address - Street 1:40 SKOKIE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-1615
Practice Address - Country:US
Practice Address - Phone:800-527-6797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001386964252Medicaid