Michael R Perry, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036058493 Issued in IL

Practice address

10 W Linden St
Freeport, IL 61032-3310

Phone

(815) 599-8414

Fax

(815) 599-8469

NPI assigned

Feb 27, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Freeport Memorial Hospital

  • Health Educator
  • Freeport, IL
  • NPI 1326880386
  NPD (past)

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508889600000",
    "number": "1972579175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 W EXCHANGE ST",
            "address_2": "PO BOX 268",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610324030",
            "telephone_number": "815-599-7958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 W LINDEN ST",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610323310",
            "telephone_number": "815-599-8414",
            "fax_number": "815-599-8469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2017-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036058493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036058493",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L64158",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pearl City Comm Unit Dist 200
• Pearl Pavilion LLC
• Rebecca Lynn Pedersen, MD
• Olivia Louise Pehl, D.C.
• Melina Mairoby Pereira Petit, DDS
• Mindy Sue Pettenger
• Trisha A Phillips, MS, CSADC, MISA I
• Kathleen Picci
• Madison E Pickard, PT
• Sarah Pillow, COTA/L

• Family Medicine Physician in Freeport, IL
• Providers in Freeport, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.