Laura Ann Perrino, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

085005321 Issued in IL

Practice address

4400 W 95TH St
Suite 205
Oak Lawn, IL 60453-2654

Phone

(708) 346-4040

Fax

(708) 346-3287

NPI assigned

Jul 24, 2013

Sex

Female

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

Credentials

Physician Assistant

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1972945467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 W 95TH ST",
            "address_2": "SUITE 205",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532654",
            "telephone_number": "708-346-4040",
            "fax_number": "708-346-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W 95TH ST",
            "address_2": "SUITE 205",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532654",
            "telephone_number": "708-346-4040",
            "fax_number": "708-346-3287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRINO",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-24",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085005321",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0003751",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Surgical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; 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.