Individual provider Active NPI

Lamorris L Perry, MD

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1043328255
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036069919 Issued in IL
Practice address
2045 W. Washington Blvd M/C 698
Chicago, IL 60612-2428
Phone
(312) 996-2000
Fax
(312) 413-7812
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036069919 IL Primary

Addresses

Primary practice location

2045 W. Washington Blvd M/C 698
Chicago, IL 60612-2428

Mailing address

1818 Heather Hill
Flossmoor, IL 60422
Phone (773) 233-4100

Other identifiers 1

IdentifierTypeStateIssuer
036069919MedicaidIL

Other names 1

  • Lamorris L. Perry Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041109000453 IL Practitioner - Pediatric Medicine 3678536877 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Aug 18, 2017 Accepting new patients
Cook County Pediatrics CurrentSince Aug 18, 2017 Accepting new patients
Cook County Current Accepting new patients
Amani Trinity United Community Health Corporation PastSince Aug 20, 2008 Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1900 W Polk St
Ste 1200
Chicago, IL 60612

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1043328255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 HEATHER HILL",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "60422",
            "telephone_number": "773-233-4100",
            "fax_number": "773-233-8542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 W. WASHINGTON BLVD M/C 698",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122428",
            "telephone_number": "312-996-2000",
            "fax_number": "312-413-7812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "LAMORRIS",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036069919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036069919",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAMORRIS",
            "last_name": "PERRY",
            "middle_name": "L.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.