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ROBERTO GORDILLO PEREZ MD NPI 1407084759


NPI Information

NPI: 1407084759
Provider Name: ROBERTO GORDILLO PEREZ, MD
Classification: Pediatrics - 2080P0210X
Entity Type: Individual

Specialization: Pediatric Nephrology

PECOS Registration: Yes

Address:
530 NE GLEN OAK AVE
DEPARTMENT OF PEDIATRICS
PEORIA, IL
ZIP 61637
Phone: (309) 624-3313
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Roberto Gordillo Perez, MD is a pediatric nephrology pediatrics in Peoria, IL with 22 years of experience. The provider is a pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy. Roberto Gordillo Perez, MD NPI is 1407084759. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

530 NE GLEN OAK AVE
DEPARTMENT OF PEDIATRICS
PEORIA, IL
ZIP 61637-001
Phone: (309) 624-3313
Fax: (309) 655-2565

The NPI 1407084759 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/25/2009 and was last updated on 4/12/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics036.126924ILLINOISNo
22080P0210XPediatricsPediatric Nephrology036.126924ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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