Individual provider Active NPI

Cynthia Perez

  • Pediatrics Physician
  • Waukegan, IL
National Provider Identifier
1598157281
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA12320400 Issued in NJ
Practice address
922 Walnut St
Waukegan, IL 60085-2848
Phone
(847) 287-6077
NPI assigned
Mar 4, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA12320400 NJ Primary

Addresses

Primary practice location

922 Walnut St
Waukegan, IL 60085-2848

Mailing address

922 Walnut St
Waukegan, IL 60085-2848
Phone (847) 287-6077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20240928000307 NJ Practitioner - Pediatric Medicine 6901337104 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA12320400NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince Jul 15, 2024 Accepting new patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince Jul 15, 2024 Accepting new patients
Monmouth Medical Center Inc Past Accepting new patients

Locations

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

125 Paterson St
Ste 6140
New Brunswick, NJ 08901
Phone (732) 235-6230

Organizations & group practices 3

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": "1425427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1598157281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 WALNUT ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852848",
            "telephone_number": "847-287-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 WALNUT ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852848",
            "telephone_number": "847-287-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "CYNTHIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-04",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA12320400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

Verify at the official NPI Registry.