Active NPI
Rita Maria Lewis-Perry, M.D.
- Psychiatry Physician
- South Holland, IL
National Provider Identifier
1285761312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Practice address
- 16233 Wausau Ave
South Holland, IL 60473-2157 - Phone
- (708) 296-1759
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 01044247A | IN | |
| Psychiatry Physician | 2084P0800X | IL | Primary |
Addresses
Primary practice location
16233 Wausau Ave
South Holland, IL 60473-2157
Mailing address
16760 Carrington Dr
South Holland, IL 60473-4612
Phone (708) 895-1701
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1605754 | Other | IL | BLUE CROSS BLUE SHIELD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-084974 | IL | MD | Psychiatry Physician |
| 01044247A | IN | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285761312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16760 CARRINGTON DR",
"city": "SOUTH HOLLAND",
"state": "IL",
"postal_code": "604734612",
"telephone_number": "708-895-1701",
"fax_number": "708-418-0620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16233 WAUSAU AVE",
"city": "SOUTH HOLLAND",
"state": "IL",
"postal_code": "604732157",
"telephone_number": "708-296-1759"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS-PERRY",
"first_name": "RITA",
"middle_name": "MARIA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IN",
"license": "01044247A",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "1605754",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Holland, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.