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General NPI Number Information
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NPI Number | 1669699153
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Entity Type | Individual
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Provider Name | FEYCE M PERALTA M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 251 E HURON ST STE FEINBERG
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City | CHICAGO
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State | IL
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Zip | 60611-2908
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Country | US
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Telephone | 312-695-0061
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Fax | 312-695-9013
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Provider Business Mailing Address
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Address Line | 410 W 10TH AVE N416 DOAN HALL
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City | COLUMBUS
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State | OH
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Zip | 43210-1240
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Country | US
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Telephone | 614-293-8487
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 57.011429
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License Number State | OH
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