Active NPI
Michael Patrick Perra, DO
- Pediatrics Physician
- Park Ridge, IL
National Provider Identifier
1043013642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 125086850
- Practice address
- 1675 Dempster St
Park Ridge, IL 60068-1110 - Phone
- (847) 723-2210
- Fax
- (847) 723-6987
- NPI assigned
- Mar 29, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 125086850 | IL | Primary |
Addresses
Primary practice location
1675 Dempster St
Park Ridge, IL 60068-1110
Mailing address
1675 Dempster St FL 1
Park Ridge, IL 60068-1110
Phone (847) 318-9300
Other practice location 1
1675 Dempster St Fl 1
Park Ridge, IL 60068-1110
Phone (847) 318-9300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125086850 | IL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocate Health and Hospitals Corporation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750464000000",
"number": "1043013642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1675 DEMPSTER ST FL 1",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600681110",
"telephone_number": "847-318-9300",
"fax_number": "847-723-9583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1675 DEMPSTER ST",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600681110",
"telephone_number": "847-723-2210",
"fax_number": "847-723-6987"
}
],
"practiceLocations": [
{
"address_1": "1675 Dempster St Fl 1",
"address_purpose": "LOCATION",
"city": "Park Ridge",
"state": "IL",
"postal_code": "600681110",
"country_code": "US",
"telephone_number": "847-318-9300",
"fax_number": "847-723-9583",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PERRA",
"first_name": "MICHAEL",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-03-29",
"last_updated": "2025-06-21",
"certification_date": "2025-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "125086850",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.