Eric Perez

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209.030477 Issued in IL

Practice address

1615 N Convent St Ste 1
Bourbonnais, IL 60914-1081

Phone

(815) 937-5200

NPI assigned

Aug 8, 2024

Last updated

Sep 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Digestive Diseases Consultants of Kankakee, SC

  • Gastroenterology Physician
  • Bourbonnais, IL
  • NPI 1407966302
  Medicare reassignment NPD

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1366273740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 N CONVENT ST STE 1",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 N CONVENT ST STE 1",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141081",
            "telephone_number": "815-937-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "ERIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-08",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.030477",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041428396",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pathik K Patel, DMD
• Shefali Patel, MPT
• Susan Patel, DDS
• Tayler Peachey, O.D.
• Derek Pequette, PT
• Heather Elizabeth Perez, PSY.D.
• Virginia Perez, LCSW, LICSW
• Ashley Perry, PTA
• Megan Pfeifer, LCSW
• Ashley Mae Phelan

• Nurse Practitioner in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.