Active NPI
Jay I Perlman, MD PHD
- Ophthalmology Physician
- Hines, IL
National Provider Identifier
1477533669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 036082464
- Practice address
- 5000 S 5TH Ave
Surgery Service
Hines, IL 60141-3030 - Phone
- (708) 202-5134
- Fax
- (708) 202-2493
- NPI assigned
- Jan 23, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 036082464 | IL | Primary |
| Neuropathology Physician | 207ZN0500X | 36082464 | IL |
Addresses
Primary practice location
5000 S 5TH Ave
Surgery Service
Hines, IL 60141-3030
Mailing address
5000 S 5TH Ave
Surgery Service
Hines, IL 60141-3030
Phone (708) 202-5134
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36082464 | Medicaid | IL |
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, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36082464 | IL | MD | Neuropathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423526400000",
"number": "1477533669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5000 S 5TH AVE",
"address_2": "SURGERY SERVICE",
"city": "HINES",
"state": "IL",
"postal_code": "601413030",
"telephone_number": "708-202-5134",
"fax_number": "708-202-2493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 S 5TH AVE",
"address_2": "SURGERY SERVICE",
"city": "HINES",
"state": "IL",
"postal_code": "601413030",
"telephone_number": "708-202-5134",
"fax_number": "708-202-2493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERLMAN",
"first_name": "JAY",
"middle_name": "I",
"credential": "MD PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-23",
"last_updated": "2015-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IL",
"license": "036082464",
"primary": true
},
{
"code": "207ZN0500X",
"taxonomy_group": "",
"desc": "Pathology, Neuropathology",
"state": "IL",
"license": "36082464",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "36082464",
"state": "IL"
}
],
"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 Feb 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.