Provider Demographics
NPI:1154209435
Name:PEREZ, EMMA FRANCES (MGC)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:FRANCES
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 W SUPERIOR ST APT G
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-5656
Mailing Address - Country:US
Mailing Address - Phone:516-592-0294
Mailing Address - Fax:
Practice Address - Street 1:1655 W SUPERIOR ST APT G
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-5656
Practice Address - Country:US
Practice Address - Phone:516-592-0294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAGC593170300000X
IL246.000995170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS