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NPI Code Detail

MEDICARE: JENNIFER PEREZ HERNANDEZ LSW

MEDICARE: JENNIFER PEREZ HERNANDEZ LSW
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
1104100000XSocial Worker150.117601IL

General Provider Information

NPI Number : 1346036563
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER PEREZ HERNANDEZ LSW
Provider Business Mailing Address
First Line : 6815 W 63RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60638-4048
Country : US
Telephone Number : 708-304-3010
Fax Number :
Provider Business Practice Location Address
First Line : 6815 W 63RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60638-4048
Country : US
Telephone Number : 708-304-3010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2025
Last Update Date : 01/07/2026

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