Provider Demographics
NPI:1568662682
Name:MUHAMMAD ALVI MD SC
Entity Type:Organization
Organization Name:MUHAMMAD ALVI MD SC
Other - Org Name:WESTERN-FOSTER MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OLEG
Authorized Official - Middle Name:
Authorized Official - Last Name:IVANOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-784-1000
Mailing Address - Street 1:5214 N WESTERN AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-2589
Mailing Address - Country:US
Mailing Address - Phone:773-784-1000
Mailing Address - Fax:773-784-1398
Practice Address - Street 1:5214 N WESTERN AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-2589
Practice Address - Country:US
Practice Address - Phone:773-784-1000
Practice Address - Fax:773-784-1398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036087467174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036087467Medicaid
IL036087467Medicaid