Doctor Name: | ABEL PEREYRA |
NPI Number: | 1285059956 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 036042937 |
Business Practice Address: | 113 Larue St Park Forest, IL - 604661224 |
Business Phone Number: | 7087481408 |
Business Fax Number: | |
Mailing Address: | 113 Larue St, PARK FOREST |
State: | IL |
Postal Code: | 604661224 |
Phone Number: | 7087481408 |
Fax Number: | |
NPI Enumeration Date: | 03/04/2014 |
NPI Last Update Date: | 03/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 036042937 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |