Organization Name: | MANUEL PEREZ, M.D.,S.C. |
NPI Number: | 1053716795 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MANUEL PEREZ (OWNER) |
Mailing Address: | 19621 La Grange Rd Mokena |
State: | IL US |
Postal Code: | 604489360 |
Phone Number: | 7084654559 |
Fax Number: | |
NPI Enumeration Date: | 10/23/2014 |
NPI Last Update Date: | 10/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM2500X |
License Number: | 036084064 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Medical Specialty |
Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |