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NPI Code Detail

MEDICARE: KATHRYN S MERKLE LCSW, MPH, RDN, LDN

MEDICARE: KATHRYN S MERKLE LCSW, MPH, RDN, LDN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian164.005634IL
21041C0700XClinical Social Worker149.024066IL

General Provider Information

NPI Number : 1285681080
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN S MERKLE LCSW, MPH, RDN, LDN
Provider Business Mailing Address
First Line : 3921 N LINCOLN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60613-2417
Country : US
Telephone Number : 312-533-0707
Fax Number : 312-873-4003
Provider Business Practice Location Address
First Line : 3921 N LINCOLN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60613-2417
Country : US
Telephone Number : 312-533-0707
Fax Number : 312-873-4003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2006
Last Update Date : 02/18/2022

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