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NPI Code Detail

MEDICARE: KATHRYN MERRICK APRN

MEDICARE: KATHRYN MERRICK APRN
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
1363LF0000XFamily Nurse Practitioner209010583IL

General Provider Information

NPI Number : 1811320989
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN MERRICK APRN
Provider Business Mailing Address
First Line : 4051 N LINCOLN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-3009
Country : US
Telephone Number : 866-389-2727
Fax Number :
Provider Business Practice Location Address
First Line : 4051 N LINCOLN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-3009
Country : US
Telephone Number : 866-389-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2013
Last Update Date : 07/23/2020

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