Manuel Perez, M.D.,S.C.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

036084064 Issued in IL

Legal business name

MANUEL PEREZ, M.D.,S.C.

Practice address

19621 La Grange Rd
Mokena, IL 60448-9360

Phone

(708) 465-4559

NPI assigned

Oct 23, 2014

Last updated

Dec 20, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Manuel Perez, M.D.

Title

Owner

Phone

(708) 465-4559

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639958400000",
    "number": "1053716795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19934 WOLF RD",
            "address_2": "#558",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604482101",
            "telephone_number": "708-465-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19621 LA GRANGE RD",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604489360",
            "telephone_number": "708-465-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANUEL PEREZ, M.D.,S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-23",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-465-4559",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IL",
            "license": "036084064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas P Maloney, DDS
• Alyson Mangin
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• Sheila Marie Mara, FNP
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• Robert William Marquis, M.D.

• Medical Specialty Clinic/Center in Mokena, IL
• Providers in Mokena, IL by specialty
• Medical Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.