Jose Antonio Rivas-Perez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.018913 Issued in IL

Practice address

999 Civic Center Dr
3Rd Floor
Niles, IL 60714-3224

Phone

(847) 588-8476

Fax

(847) 588-8454

NPI assigned

Nov 3, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1831641000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3504 N SOUTHPORT AVE # 4S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576877",
            "telephone_number": "248-933-5823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 CIVIC CENTER DR",
            "address_2": "3RD FLOOR",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143224",
            "telephone_number": "847-588-8476",
            "fax_number": "847-588-8454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVAS-PEREZ",
        "first_name": "JOSE",
        "middle_name": "ANTONIO",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-03",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018913",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "IL",
            "license": "1001163",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Retina Institute of Illinois PC
• Retina Surgery Center
• Retinalysis, Inc.
• Jennifer Jiyun Rhee, PTA
• Nikola Ristic, PHARMD
• Annaliza Gaye Rivera, PT
• RNP Services LLC
• Ralph N. Robbins, D.D.S.
• Erika Robeck, M.A., CF-SLP
• Nadine Beth Robertson Dimare, LCSW

• Clinical Social Worker in Niles, IL
• Providers in Niles, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; 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.