MEDICARE: VALERIE PEREZ PSYD/ HSPP

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	103T00000X	Psychologist	071009045	IL
2	103TC0700X	Clinical Psychologist	20042756A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952651408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE PEREZ PSYD/ HSPP

Provider Business Mailing Address
First Line	:	980 N MICHIGAN AVE
Second Line	:	STE 1090 PMB 344989
City	:	CHICAGO
State	:	IL
Zip	:	60611-4521
Country	:	US
Telephone Number	:	866-413-1988
Fax Number	:	866-628-8599

Provider Business Practice Location Address
First Line	:	1101 CUMBERLAND XING STE 108
Second Line	:
City	:	VALPARAISO
State	:	IN
Zip	:	46383-2356
Country	:	US
Telephone Number	:	866-413-1988
Fax Number	:	866-628-8599

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

Provider Enumeration Date	:	09/12/2012
Last Update Date	:	01/27/2026

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