MR. JESSE M PEREZ (NPI# 1730636374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730636374 |
| Entity Type | Individual |
| Full Name | MR. JESSE M PEREZ |
| Credential | LCPC |
| Practice Address |
1242 Fernleaf Dr Crystal Lake IL 60014-8996 |
| Mailing Address |
1242 Fernleaf Drvie Crystal Lake IL 60014-8996 |
| Practice Telephone | 8158147475 |
| Mailing Telephone | 8158147475 |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2020-10-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
180013206 | IL | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | STATE OF ILLINOIS DEPARTMENT OF FINACIAL AND PROFESSIONAL REGULA | 180013206 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 715 Lake St Ste 517a, Oak Park, IL 603011414 | 7085291940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790324143 | Jesse William Perez | Behavior Technician | 40687 Dutton St, Cherry Valley, CA 92223-4533 | 2020-01-02 |
| 1396214888 | Jesse Perez II | Pharmacist | 14794 Velvet St, Chino Hills, CA 91709-2067 | 2018-11-14 |
| 1760893580 | Jesse Perez | Social Worker | 14375 Hubbard St, Livonia, MI 48154-4133 | 2014-05-14 |
| 1902440332 | Jesse Perez | Behavior Technician | 677 Cliffside Dr # 677, San Dimas, CA 91773-2957 | 2019-10-29 |
| 1538701974 | Jesse Ryan Perez | Behavior Technician | 202 E Airport Dr Ste 150, San Bernardino, CA 92408-3429 | 2019-10-16 |
| 1457992596 | Jesse Perez | Behavioral Analyst | 12395 Lewis St Ste 202, Garden Grove, CA 92840-4694 | 2019-09-30 |
| 1992159693 | Jesse Perez | Counselor | 4335 Atlantic Ave, Long Beach, CA 90807-2803 | 2016-04-19 |
| Street Address |
1242 FERNLEAF DR |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60014-8996 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497394720 | Lorelei Mariano | Physical Therapist | 350 E Congress Parkway Ste A, Crystal Lake, IL 60014 | 2020-01-03 |
| 1396227070 | Behavioral Services for Autism, Inc | Behavioral Analyst | 1095 Pingree Road, Suite 204, Crystal Lake, IL 60014 | 2018-08-30 |
| 1831635564 | Isis Mendoza-garnica | Counselor | 6803 Rose Ave, Crystal Lake, IL 60014 | 2017-01-19 |
| 1134664402 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 525 E Congress Parkway, Suite 200, Crystal Lake, IL 60014 | 2016-12-22 |
| 1306394051 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 177 W Virginia Street, Crystal Lake, IL 60014 | 2016-09-12 |
| 1124492830 | Align Spine & Orthopaedics | Durable Medical Equipment & Medical Supplies | 60 B West Terra Cotta Ave, #265, Crystal Lake, IL 60014 | 2015-11-18 |
| 1558747428 | Shabana Nawaz | Optometrist | 4777 Northwest Highway, Crystal Lake, IL 60014 | 2015-08-03 |
| 1548649205 | Daniel Okon | Social Worker | 304 Charllote Ave, Crystal Lake, IL 60014 | 2015-05-27 |
| 1154729838 | Crystal Lake Center for Chronic Pain Sc | Nurse Practitioner | 1 South Northwest Highway, Crystal Lake, IL 60014 | 2014-12-12 |
| 1558763581 | Brooke Nicole Grandt | Occupational Therapist | 394 Heisler Ct, Crystal Lake, IL 60014 | 2014-09-22 |
| Find all providers in zip 60014 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467918037 | Dipa Patel | Counselor | 457 Coventry Ln Ste 116, Crystal Lake, IL 60014-7571 | 2019-02-19 |
| 1679078315 | Kevin Becker | Counselor | 145 S Virginia St Ste 3, Crystal Lake, IL 60014-7226 | 2018-03-26 |
| 1295108769 | Victoria Nett | Counselor | 91 N Oak St, Crystal Lake, IL 60014-4127 | 2015-11-05 |
| 1598135675 | Jennifer Lynn Johnson | Counselor | 457 Coventry Ln # 129a, Crystal Lake, IL 60014-7571 | 2015-10-01 |
| 1619377637 | Lantern Therapy Services, Ltd | Counselor | 457 Coventry Ln Ste 129a, Crystal Lake, IL 60014-7571 | 2014-08-27 |
| 1962823542 | Carol D Trejo Kroeger | Counselor | 1095 Pingree Rd Ste 202, Crystal Lake, IL 60014 | 2013-12-26 |
| 1033559273 | Gabrielle Anne Johnson | Counselor | 530 Rockland Rd Fl 1, Suite 100, Crystal Lake, IL 60014-4131 | 2013-07-02 |
| 1528314135 | Jennifer Marie Loni | Counselor | 1095 Pingree Rd Ste 204, Crystal Lake, IL 60014-1727 | 2012-08-01 |
| 1457582181 | Ronald W Hall II | Counselor | 80 S Oriole Trl, Crystal Lake, IL 60014-5842 | 2009-07-29 |
| 1023282878 | Bennett & Bennett | Counselor | 4501 Route 176, Crystal Lake, IL 60014 | 2008-04-14 |
| Find all providers in CRYSTAL LAKE | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60014 |
Please comment or provide details below to improve the information on MR. JESSE M PEREZ.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.