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NPI Code Detail

MEDICARE: DR. HOLLY PEREZ MD

MEDICARE: DR. HOLLY PEREZ MD
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
1207Q00000XFamily Medicine Physician125077837IL
2207Q00000XFamily Medicine Physician036.169270IL

General Provider Information

NPI Number : 1023532603
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HOLLY PEREZ MD
Provider Business Mailing Address
First Line : 312 E WASHINGTON ST
Second Line :
City : WEST CHICAGO
State : IL
Zip : 60185-2230
Country : US
Telephone Number : 239-961-8380
Fax Number :
Provider Business Practice Location Address
First Line : 245 W ROOSEVELT RD STE 150
Second Line :
City : WEST CHICAGO
State : IL
Zip : 60185-4818
Country : US
Telephone Number : 630-293-4124
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2017
Last Update Date : 07/23/2024

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Directions to “ DR. HOLLY PEREZ MD” Practice Location

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