Individual provider Active NPI

Angelica Perez, O.D.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1174606206
Registry record updated Aug 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-009673 Issued in IL
Practice address
55 E Washington St
Suite 647
Chicago, IL 60602-2103
Phone
(312) 332-0921
Fax
(312) 332-0963
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-009673 IL Primary

Addresses

Primary practice location

55 E Washington St
Suite 647
Chicago, IL 60602-2103

Mailing address

55 E Washington St
Suite 647
Chicago, IL 60602-2103
Phone (312) 332-0921

Other names 1

  • Dr. Angelica Rodriguez Professional 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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040922000687 IL Practitioner - Optometry 0446242341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perez Eye Care, IncGroup PAC ID 3678565579, 2 clinicians

Practice addresses (Care Compare)

2252 W Cermak Rd
Chicago, IL 60608-3917
Phone (773) 847-1581

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-009673ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Perez Eye Care, Inc Optometrist CurrentSince Jun 1, 2004 Accepting new patients

Locations

25 E Washington St
Ste 820
Chicago, IL 60602
Phone (312) 332-0921

2252 W Cermak Rd
Chicago, IL 60608
Phone (773) 847-1581

Interoperability endpoints

  • Direct secure messaging: 1234@perezeyecare.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375747200000",
    "number": "1174606206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E WASHINGTON ST",
            "address_2": "SUITE 647",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606022103",
            "telephone_number": "312-332-0921",
            "fax_number": "312-332-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 E WASHINGTON ST",
            "address_2": "SUITE 647",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606022103",
            "telephone_number": "312-332-0921",
            "fax_number": "312-332-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "ANGELICA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2013-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELICA",
            "last_name": "RODRIGUEZ",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.