Provider Demographics
NPI:1023342417
Name:PERALES, HUGO GERARDO (MSW)
Entity type:Individual
Prefix:MR
First Name:HUGO
Middle Name:GERARDO
Last Name:PERALES
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3529 S 59TH CT
Mailing Address - Street 2:APT 3
Mailing Address - City:CICERO
Mailing Address - State:IL
Mailing Address - Zip Code:60804-4158
Mailing Address - Country:US
Mailing Address - Phone:773-803-4452
Mailing Address - Fax:773-549-9411
Practice Address - Street 1:3529 S 59TH CT
Practice Address - Street 2:APT 3
Practice Address - City:CICERO
Practice Address - State:IL
Practice Address - Zip Code:60804-4158
Practice Address - Country:US
Practice Address - Phone:773-803-4452
Practice Address - Fax:773-549-9411
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150008431104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker