Active NPI
Michele S Perlis, M.D.
- Obstetrics & Gynecology Physician
- Crystal Lake, IL
National Provider Identifier
1245281054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 036080986
- Practice address
- 260 E Congress Pkwy
Crystal Lake, IL 60014 - Phone
- (815) 477-0300
- Fax
- (815) 477-0301
- NPI assigned
- May 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 036080986 | IL | Primary |
Addresses
Primary practice location
260 E Congress Pkwy
Crystal Lake, IL 60014
Mailing address
260 E Congress Pkwy
Crystal Lake, IL 60014-6235
Phone (815) 477-0300
Other practice location 1
10400 Haligus Rd
Huntley, IL 60142-9553
Phone (224) 654-0000
Other practice location 2
4201 W Medical Center Dr
McHenry, IL 60050-8409
Phone (815) 344-5000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036080986 | Other | IL | STATE LICENSE |
| 036080986 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539907200000",
"number": "1245281054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "260 E CONGRESS PKWY",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600146235",
"telephone_number": "815-477-0300",
"fax_number": "815-477-0301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 E CONGRESS PKWY",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "60014",
"telephone_number": "815-477-0300",
"fax_number": "815-477-0301"
}
],
"practiceLocations": [
{
"address_1": "10400 Haligus Rd",
"address_purpose": "LOCATION",
"city": "Huntley",
"state": "IL",
"postal_code": "601429553",
"country_code": "US",
"telephone_number": "224-654-0000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4201 W Medical Center Dr",
"address_purpose": "LOCATION",
"city": "McHenry",
"state": "IL",
"postal_code": "600508409",
"country_code": "US",
"telephone_number": "815-344-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PERLIS",
"first_name": "MICHELE",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-15",
"last_updated": "2018-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IL",
"license": "036080986",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "036080986",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036080986",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.