Individual provider Active NPI

Perry Marshall, D.O

  • Emergency Medicine Physician
  • Kankakee, IL
National Provider Identifier
1770522260
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Practice address
500 W Court St
Kankakee, IL 60901-3661
Phone
(815) 937-2100
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X IL Primary

Addresses

Primary practice location

500 W Court St
Kankakee, IL 60901-3661

Mailing address

555 W Court St
Kankakee, IL 60901-3675
Phone (888) 828-3193

Other identifiers 1

IdentifierTypeStateIssuer
4622394OtherBCBS

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
036-106461ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Webster Emergency Physicians Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Kankakee County, LLC Emergency Medicine Past Accepting new patients

Organizations & group practices 2

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1770522260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W COURT ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013675",
            "telephone_number": "888-828-3193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W COURT ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013661",
            "telephone_number": "815-937-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "PERRY",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4622394",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kankakee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.