Provider Demographics
NPI:1265806947
Name:ALVAREZ, VICTOR SR (MA)
Entity type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:
Last Name:ALVAREZ
Suffix:SR
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 WILDFLOWER WAY
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4965
Mailing Address - Country:US
Mailing Address - Phone:804-909-4428
Mailing Address - Fax:
Practice Address - Street 1:1400 S AUSTIN BLVD
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:IL
Practice Address - Zip Code:60804-1003
Practice Address - Country:US
Practice Address - Phone:708-329-4029
Practice Address - Fax:708-222-1495
Is Sole Proprietor?:No
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional