Provider Demographics
NPI:1659533701
Name:PEREZ-REISLER, MARISA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARISA
Middle Name:
Last Name:PEREZ-REISLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 SKOKIE BLVD STE 1A
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2822
Mailing Address - Country:US
Mailing Address - Phone:847-892-7300
Mailing Address - Fax:847-892-7301
Practice Address - Street 1:601 SKOKIE BLVD STE 1A
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2822
Practice Address - Country:US
Practice Address - Phone:847-892-7300
Practice Address - Fax:847-892-7301
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI162982084P0800X, 2084P0804X
IL036.1452352084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry