Healthcare Provider Details

I. General information

NPI: 1285626101
Provider Name (Legal Business Name): CHERYL L. PERLIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 06/07/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1780 GREEN BAY RD STE 204
HIGHLAND PARK IL
60035-3276
US

IV. Provider business mailing address

1780 GREEN BAY RD STE 204
HIGHLAND PARK IL
60035-3276
US

V. Phone/Fax

Practice location:
  • Phone: 847-295-5997
  • Fax:
Mailing address:
  • Phone: 847-295-5997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number036.078030
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: