Provider Demographics
NPI:1275813883
Name:PEREZ, FELIPE LUIS (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:FELIPE
Middle Name:LUIS
Last Name:PEREZ
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 W CERMAK RD
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:IL
Mailing Address - Zip Code:60804-2531
Mailing Address - Country:US
Mailing Address - Phone:708-863-7734
Mailing Address - Fax:
Practice Address - Street 1:4800 W CERMAK RD
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:IL
Practice Address - Zip Code:60804-2531
Practice Address - Country:US
Practice Address - Phone:708-863-7734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051293903183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist