Heather Elizabeth Perez, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.010128 Issued in IL

Practice address

755 Almar Pkwy
Bourbonnais, IL 60914-2392

Phone

(317) 366-9559

NPI assigned

Oct 15, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
• IL PPO Downstate
• IL HMO C-SNP

Interoperability endpoints

• Direct secure messaging: lifestancehealth.heatherwells@146897.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Edgewood Clinical Services, P.C.

  • Psychologist
  • Naperville, IL
  • NPI 1295914646
  Medicare reassignment NPD
• Edgewood Clinical Services, P.C.

  • Community/Behavioral Health Agency
  • Naperville, IL
  • NPI 1366784837
  NPD (past)
• Psychology Specialists LTD

  • Clinical Psychologist
  • Bloomington, IL
  • NPI 1053368605
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1013559665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 ALMAR PKWY",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142392",
            "telephone_number": "317-366-9559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 ALMAR PKWY",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142392",
            "telephone_number": "317-366-9559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "HEATHER",
        "middle_name": "ELIZABETH",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-15",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.010128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shefali Patel, MPT
• Susan Patel, DDS
• Tayler Peachey, O.D.
• Derek Pequette, PT
• Eric Perez
• Virginia Perez, LCSW, LICSW
• Ashley Perry, PTA
• Megan Pfeifer, LCSW
• Ashley Mae Phelan
• Bradley D Phillips, PT

• Clinical Psychologist in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.