Perez, Jesse M

Perez, Jesse M is an individual health care provider with primary practice located at 1242 Fernleaf Dr , Crystal Lake IL 60014-8996. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Perez, Jesse M can be contacted via phone (815) 814-7475.

Contact Information

Primary practice address
1242 Fernleaf Dr Crystal Lake IL 60014-8996
Phone: (815) 814-7475
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 180013206 Illinois

Profile Details

NPI number 1730636374
LBN Legal business name Perez, Jesse M
Credentials LCPC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 1st, 2016
Last updated Oct 27th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730636374 NPPES
Illinois Other 180013206 STATE OF ILLINOIS DEPARTMENT OF FINACIAL AND PROFESSIONAL REGULATION

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