Healthcare Provider Details

I. General information

NPI: 1548847684
Provider Name (Legal Business Name): LIANA HINDS-PEREIRA DO, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 S WOOD ST
CHICAGO IL
60612-4325
US

IV. Provider business mailing address

2723 E ROBINSON AVE
FRESNO CA
93726-5620
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-4185
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number036.170531
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: