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Individual

CLARA T PEREZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1 OLD FRANKFORT WAY, FRANKFORT, IL 60423-1719
(708) 206-1300
(708) 206-1399
Mailing address
833 W 15TH PL, UNIT 815, CHICAGO, IL 60608-1429
(708) 206-1300
(708) 206-1399

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036067468
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
018896
VALUEOPTIONS PROVIDER #
IL
01
036067468
LICENSE #
IL
05
036067468
IL
01
119475
COMPSYCH PROVIDER #
IL
01
155000
PSYCHEALTH PROVIDER #
IL
01
166548
HARMONY PROVIDER #
IL
01
31603579
BCBS
IL
01
31603879
BCBS PROVIDER #
IL
01
35928
AMERICAID PROVIDER #
IL
01
363762147
TAX ID #
IL
Enumeration date
03/18/2006
Last updated
05/11/2021
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