Organization Active NPI

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

  • Medical Specialty Clinic/Center
  • Mokena, IL
National Provider Identifier
1053716795
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 036084064 IL Primary

Addresses

Primary practice location

19621 La Grange Rd
Mokena, IL 60448-9360

Mailing address

19934 Wolf Rd
#558
Mokena, IL 60448-2101
Phone (708) 465-4559

National Provider Directory

National Provider Directory

Locations

2315 E 93rd St
Ste 236
Chicago, IL 60617
Phone (630) 571-1100

19934 Wolf Rd
Unit 558
Mokena, IL 60448

NPI Registry JSON

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": []
}

Other providers in Mokena, IL

Sources for this page

  • 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.