Provider Demographics
NPI:1912358599
Name:CORVITA HEALTH & ASSOCIATES LTD
Entity Type:Organization
Organization Name:CORVITA HEALTH & ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:773-432-4800
Mailing Address - Street 1:1006 S MICHIGAN AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2216
Mailing Address - Country:US
Mailing Address - Phone:773-432-4800
Mailing Address - Fax:844-805-4742
Practice Address - Street 1:1006 S MICHIGAN AVE STE 500
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2216
Practice Address - Country:US
Practice Address - Phone:773-432-4800
Practice Address - Fax:844-805-4742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-24
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
F100316272Medicare PIN