MEDICARE: SANDRA PEREZ-MORA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist		IL

General Provider Information

NPI Number	:	1407790363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA PEREZ-MORA

Provider Business Mailing Address
First Line	:	155 HAZARD RD
Second Line	:
City	:	CARPENTERSVILLE
State	:	IL
Zip	:	60110-2249
Country	:	US
Telephone Number	:	224-425-0607
Fax Number	:

Provider Business Practice Location Address
First Line	:	7354 N MILWAUKEE AVE
Second Line	:
City	:	NILES
State	:	IL
Zip	:	60714-4339
Country	:	US
Telephone Number	:	224-251-8190
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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Directions to “ SANDRA PEREZ-MORA ” Practice Location

Language	Start Address	Practice Location

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