Peter Perrotta, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

071-003266 Issued in IL

Practice address

2625 Butterfield Rd Ste 101N
Oak Brook, IL 60523

Phone

(630) 586-0900

Fax

(630) 586-9990

NPI assigned

Jan 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 26, 2024 through Jul 26, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Perrotta and Kraus PHDS PC

  • Clinical Social Worker
  • Oak Brook, IL
  • NPI 1841740214
  NPD Authorized official

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531612800000",
    "number": "1831247055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD STE 101N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605233405",
            "telephone_number": "630-586-0900",
            "fax_number": "630-586-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD STE 101N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "60523",
            "telephone_number": "630-586-0900",
            "fax_number": "630-586-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERROTTA",
        "first_name": "PETER",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2018-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071-003266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vince A Penesis, D.D.S.
• Colin E Penn, DPT
• Sarah Penwala
• Perrotta and Kraus PHDS PC
• Perrotta and Kraus PHDS PC
• Emily Peterson, MOT
• Stephanie Petrey, LCPC
• Nida M Petronis, RPH
• Mitchell Clinton Phelps, MSW, CRSS
• Physician Services at Home S.C

• Psychologist in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.