Provider Demographics
NPI:1114699584
Name:DELUNA PEREZ, CRISTINA SUJEY
Entity Type:Individual
Prefix:MS
First Name:CRISTINA
Middle Name:SUJEY
Last Name:DELUNA PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21000 S FRANKFORT SQUARE RD STE D
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-9386
Mailing Address - Country:US
Mailing Address - Phone:708-733-0105
Mailing Address - Fax:
Practice Address - Street 1:21000 S FRANKFORT SQUARE RD STE D
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-9386
Practice Address - Country:US
Practice Address - Phone:815-220-5658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILRBT-21-174212106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician