Individual
ALEJANDRA PEREZ-TAMAYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1801 W TAYLOR ST, 3F-OCC, CHICAGO, IL 60612-4795
(312) 996-6883
(312) 413-1206
Mailing address
840 S WOOD ST # MC958, SUITE 618, CHICAGO, IL 60612-4325
(312) 355-0104
(312) 355-3764
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036065562
IL
2086S0122X
Plastic and Reconstructive Surgery Physician
036065562
IL
2086X0206X
Surgical Oncology Physician
Primary
036065562
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020052881
RAILROAD MEDICARE
IL
05
—
036065562
—
IL
01
—
202351
BCBS PROVIDER ID
IL
01
—
21622027
BCBS PROVIDER ID
IL
01
—
P00129722
RAILROAD MEDICARE
IL
Enumeration date
09/23/2005
Last updated
03/13/2021
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