Individual provider Active NPI

Richard L Persino, MD

  • Obstetrics & Gynecology Physician
  • Winfield, IL
National Provider Identifier
1396806303
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036-070985 Issued in IL
Practice address
25 N Winfield Rd
Winfield, IL 60190-1379
Phone
(630) 653-4240
Fax
(630) 315-6597
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036-070985 IL Primary

Addresses

Primary practice location

25 N Winfield Rd
Winfield, IL 60190-1379

Mailing address

25 N Winfield Rd
Winfield, IL 60190-1379
Phone (630) 653-4240

Other identifiers 1

IdentifierTypeStateIssuer
036070985 1MedicaidIL

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050902000591 IL Practitioner - Obstetrics/Gynecology 4688606262 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-070985ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Sep 1, 2020 Accepting new patients
Central Dupage Physician Group CurrentSince Sep 1, 2020 Accepting new patients
Mercy Health System Corporation CurrentSince Aug 1, 2005 Accepting new patients
Mercy Health System Corporation CurrentSince Aug 1, 2005 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

750 E Terra Cotta Ave
Ste B
Crystal Lake, IL 60014
Phone (815) 356-2323

348 S Division St
Harvard, IL 60033
Phone (815) 943-1122

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

0N025 Winfield Rd
Winfield, IL 60190
Phone (630) 832-0050

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Organizations & group practices 4

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1396806303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901379",
            "telephone_number": "630-653-4240",
            "fax_number": "630-315-6597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901379",
            "telephone_number": "630-653-4240",
            "fax_number": "630-315-6597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSINO",
        "first_name": "RICHARD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-070985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036070985 1",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winfield, IL

Sources for this page

Verify at the official NPI Registry.