Individual provider Active NPI

Jessica Annette Perez, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1487312211
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209.024422 Issued in IL
Practice address
1431 N Claremont Ave
Chicago, IL 60622-1702
Phone
(312) 491-5498
Fax
(312) 491-5012
NPI assigned
Nov 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209.024422 IL Primary

Addresses

Primary practice location

1431 N Claremont Ave
Chicago, IL 60622-1702

Mailing address

1431 N Claremont Ave
Chicago, IL 60622-1702
Phone (312) 491-5498

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220426001987 IL Practitioner - Nurse Practitioner 8820485634 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.024422ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Glaser and Associates LLC CurrentSince Jan 15, 2022 Accepting new patients

Locations

1431 N Claremont Ave
Fl 1
Chicago, IL 60622
Phone (312) 491-5498

1431 N Claremont Ave
Chicago, IL 60622
Phone (312) 491-5498

1431 N Western Ave
Ste 306
Chicago, IL 60622
Phone (312) 332-2226

6428 Joliet Rd
Ste 201
Countryside, IL 60525

Organizations & group practices 1

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": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1487312211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 N CLAREMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221702",
            "telephone_number": "312-491-5498",
            "fax_number": "312-491-5012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 N CLAREMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221702",
            "telephone_number": "312-491-5498",
            "fax_number": "312-491-5012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JESSICA",
        "middle_name": "ANNETTE",
        "name_prefix": "Dr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.024422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.