Jacob Thomas Perez, M.S, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096.005603 Issued in IL

Practice address

10001 S Woodlawn Ave
Chicago, IL 60628-1696

Phone

(773) 291-6173

NPI assigned

Feb 9, 2023

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1114624244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 LYNN AVE",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604461238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 S WOODLAWN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606281696",
            "telephone_number": "773-291-6173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3040 S Wabash Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606163474",
            "country_code": "US",
            "telephone_number": "312-567-7125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JACOB",
        "middle_name": "THOMAS",
        "credential": "M.S, ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.005603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gillian Marcelino Perez, RN
• Ginelly Perez, M.ED.
• Hernan Perez, OTR/L
• Ireri Perez, LMT
• Itzel Perez
• Jeanette Perez, LCSW, LPHA
• Jennifer Perez, MD
• Jessica Annette Perez, NP
• Jessica N Perez
• Johnny Perez

• Athletic Trainer in Chicago, IL
• Providers in Chicago, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.