MEDICARE: DR. ROBERT PERELMAN 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
1	208000000X	Pediatrics Physician	20881-020	WI

General Provider Information

NPI Number	:	1114283082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT PERELMAN MD

Provider Business Mailing Address
First Line	:	141 NORTHWEST POINT BLVD
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-1098
Country	:	US
Telephone Number	:	847-434-7898
Fax Number	:

Provider Business Practice Location Address
First Line	:	141 NW POINT BLVD
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-1019
Country	:	US
Telephone Number	:	847-434-7898
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2012
Last Update Date	:	04/05/2012

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