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Individual provider Active NPI

Alejandra Perez-Tamayo

  • Surgery Physician
  • Chicago, IL
National Provider Identifier
1821416165
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036.149537 Issued in IL
Practice address
1801 W. Taylor Street
Mc741
Chicago, IL 60612
Phone
(312) 996-2061
Fax
(312) 996-1214
NPI assigned
Apr 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 036.149537 IL
Surgery Physician 208600000X 036.149537 IL Primary

Addresses

Primary practice location

1801 W. Taylor Street
Mc741
Chicago, IL 60612

Mailing address

840 S Wood St Ste 518
Chicago, IL 60612-4325
Phone (312) 996-0066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201104002623 IL Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 0941610869 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook CountyGroup PAC ID 2860398088, 770 clinicians

Practice addresses (Care Compare)

1740 W Taylor St
Chicago, IL 60612-7232

1801 W Taylor St
Chicago, IL 60612-4795

1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 633-7292

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.149537ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County Surgery CurrentSince Mar 29, 2021 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Cook County Current Accepting new patients
Cook County CurrentSince Mar 29, 2021 Accepting new patients
The Board of Trustees of the University of Illinois Surgery Past Accepting new patients
John H Stroger Jr Hospital Cook County Past Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1801 W Taylor St
#3F
Chicago, IL 60612
Phone (312) 355-4300

1801 W Taylor St
#741
Chicago, IL 60612
Phone (312) 996-2061

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

840 S Wood St
Ste 518
Chicago, IL 60612

Organizations & group practices 6

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.

Hospital & facility affiliations 28

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1821416165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST STE 518",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-0066",
            "fax_number": "312-996-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W. TAYLOR STREET",
            "address_2": "MC741",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-996-2061",
            "fax_number": "312-996-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ-TAMAYO",
        "first_name": "ALEJANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-03",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "IL",
            "license": "036.149537",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036.149537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.