Active NPI
Sherie Anne Perdue, D.D.S.
- General Practice Dentistry
- Genoa, IL
National Provider Identifier
1659511632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019.016775
- Practice address
- 209 W Main St
Genoa, IL 60135-1145 - Phone
- (815) 784-6088
- Fax
- (815) 784-5199
- NPI assigned
- Mar 3, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019.016775 | IL | Primary |
Addresses
Primary practice location
209 W Main St
Genoa, IL 60135-1145
Mailing address
209 W Main St
Genoa, IL 60135-1145
Phone (815) 784-6088
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.016775 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236038400000",
"number": "1659511632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 W MAIN ST",
"city": "GENOA",
"state": "IL",
"postal_code": "601351145",
"telephone_number": "815-784-6088",
"fax_number": "815-784-5199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 W MAIN ST",
"city": "GENOA",
"state": "IL",
"postal_code": "601351145",
"telephone_number": "815-784-6088",
"fax_number": "815-784-5199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERDUE",
"first_name": "SHERIE",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-03",
"last_updated": "2009-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019.016775",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Genoa, IL
- Donald T. Miller Jr., D.M.D.
- Angela Moore
- Natural Family Health S.C.
- Northern Rehabilitation and Sports Medicine Associates
- Patricia Maria Pasillas Cardenas
- Jean Michelle Reiss, DT
- Nan Elaine Ryan
- Shree Verai Aa Medventure Inc (Genoa Family Pharmacy)
- Bethany L Skowronski
- Steven J. Disanti D.O. S.C. (D/B/A Genoa Medical Clinic)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.