Perez, Walter Daniel

Perez, Walter Daniel is an sole proprietor health care provider with primary practice located at 2859 S Pulaski Rd , Chicago IL 60623-4456. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Perez, Walter Daniel can be contacted via phone (773) 762-3333.

Contact Information

Primary practice address
2859 S Pulaski Rd Chicago IL 60623-4456
Phone: (773) 762-3333
Fax: (773) 762-5555
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036-097752 Illinois

Profile Details

NPI number 1558475996
LBN Legal business name Perez, Walter Daniel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 19th, 2006
Last updated Feb 24th, 2012 - about 14 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 1558475996 NPPES
Illinois MEDICAID 036097752-2
Illinois Other 363661051
Illinois MEDICAID 036097752-1
Illinois Other 01636255

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