Individual provider Active NPI

Manuel Perez, M.D.

  • Surgery Physician
  • Chicago, IL
National Provider Identifier
1972543916
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036084064 Issued in IL
Practice address
2301 E 93Rd St Ste 115
Chicago, IL 60617-3986
Phone
(773) 967-4130
Fax
(773) 967-4138
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036084064 IL Primary

Addresses

Primary practice location

2301 E 93Rd St Ste 115
Chicago, IL 60617-3986

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

19621 La Grange Rd
Mokena, IL 60448-9360
Phone (708) 465-4559

Other identifiers 1

IdentifierTypeStateIssuer
036084064MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mperez276011@direct.myadvocateaurora.org Direct
FHIR URL https://epicfhir.aurora.org/FHIR/myaurora/api/FHIR/DSTU2/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141119000445 IL Practitioner - General Surgery 9638209489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Puerto Rico School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

17800 Kedzie Ave
Hazel Crest, IL 60429-2029
Phone (708) 684-5340

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

2320 E 93Rd St
Chicago, IL 60617-3909
Phone (773) 967-3999

4440 W 95TH St
Oak Lawn, IL 60453-2600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036084064ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jan 27, 2023 Accepting new patients
Advocate Health & Hospitals Corp. CurrentSince Jan 27, 2023 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

2301 E 93rd St
Ste 115
Chicago, IL 60617
Phone (773) 375-0313

9831 S Western Ave
Chicago, IL 60643
Phone (773) 445-3500

29373 Network Pl
Chicago, IL 60673

2535 S King Dr
Chicago, IL 60616
Phone (312) 842-7117

333 Dixie Hwy
Chicago Hts, IL 60411
Phone (708) 756-0100

Interoperability endpoints

  • Direct secure messaging: mperez276011@direct.myadvocateaurora.org

Organizations & group practices 3

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1972543916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 E 93RD ST STE 115",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606173986",
            "telephone_number": "773-967-4130",
            "fax_number": "773-967-4138"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19621 La Grange Rd",
            "address_purpose": "LOCATION",
            "city": "Mokena",
            "state": "IL",
            "postal_code": "604489360",
            "country_code": "US",
            "telephone_number": "708-465-4559",
            "fax_number": "708-478-3036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "MANUEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036084064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036084064",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mperez276011@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "19621 La Grange Rd",
            "city": "Mokena",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604489360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/myaurora/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "19621 La Grange Rd",
            "city": "Mokena",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604489360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.