Dimitri G. Perros, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036-048039 Issued in IL

Practice address

800 Austin St
Suite 507
Evanston, IL 60202-3439

Phone

(847) 864-7760

Fax

(847) 864-0984

NPI assigned

Jul 31, 2006

Last updated

Dec 16, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Dimitri G. Perros, M.D., S.C.

  • Ophthalmology Physician
  • Evanston, IL
  • NPI 1861674558
  Authorized official Same address or phone

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1386659886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 AUSTIN ST",
            "address_2": "SUITE 507",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023439",
            "telephone_number": "847-864-7760",
            "fax_number": "847-864-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 AUSTIN ST",
            "address_2": "SUITE 507",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023439",
            "telephone_number": "847-864-7760",
            "fax_number": "847-864-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERROS",
        "first_name": "DIMITRI",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036-048039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036048039",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "131051300",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4074893",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180009714",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD",
            "identifier": "21608516",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Robert Perkins I
• Reid Michael Perlman, M.D.
• Judith Kay Perloff
• Robert A Perotti, LCSW
• Melissa Perrin, PSYD
• Ryan Perry
• Sara Perry
• Inna S Persina, M.D.
• Elene Pestvenidze
• Mariam Pestvenidze, M.D.

• Ophthalmology Physician in Evanston, IL
• Providers in Evanston, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; 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.