Individual
MICHAEL R PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 W LINDEN ST, FREEPORT, IL 61032-3310
(815) 599-8414
(815) 599-8469
Mailing address
421 W EXCHANGE ST, PO BOX 268, FREEPORT, IL 61032-4030
(815) 599-7958
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036058493
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036058493
—
IL
05
—
L64158
—
IL
Enumeration date
02/27/2006
Last updated
10/25/2017
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