Active NPI
Evelyn Perez, RN MSN ACNP-BC
- Nurse Practitioner
- Hines, IL
National Provider Identifier
1407040587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209-004795
- Practice address
- 5000 S 5TH Ave
Hines, IL 60141-3030 - Phone
- (708) 202-2586
- NPI assigned
- Aug 31, 2007
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209-004795 | IL | Primary |
Addresses
Primary practice location
5000 S 5TH Ave
Hines, IL 60141-3030
Mailing address
5000 S. 5TH Avenue
Hines, IL 60141-1449
Phone (708) 202-2586
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
- Master of Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209-004795 | IL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270771200000",
"number": "1407040587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5000 S. 5TH AVENUE",
"city": "HINES",
"state": "IL",
"postal_code": "601411449",
"telephone_number": "708-202-2586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 S 5TH AVE",
"city": "HINES",
"state": "IL",
"postal_code": "601413030",
"telephone_number": "708-202-2586"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "EVELYN",
"name_prefix": "Mrs.",
"credential": "RN MSN ACNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-31",
"last_updated": "2010-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209-004795",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hines, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.