Healthcare Provider Details

I. General information

NPI: 1386571396
Provider Name (Legal Business Name): ERIKA M PEREZ HERRICK LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2930 W GRAND AVE
CHICAGO IL
60622-4308
US

IV. Provider business mailing address

2930 W GRAND AVE
CHICAGO IL
60622-4308
US

V. Phone/Fax

Practice location:
  • Phone: 872-817-9858
  • Fax: 773-661-6993
Mailing address:
  • Phone: 872-817-9858
  • Fax: 773-661-6993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.113411
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: