MEDICARE: DR. JOHN G MERKLING D.C.

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
1	111N00000X	Chiropractor	038006525	IL
2	111N00000X	Chiropractor	1129	AR
3	111N00000X	Chiropractor	3962	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5682024	OTHER	IL	BC/BS PROVIDER NUMBER

General Provider Information

NPI Number	:	1821095589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN G MERKLING D.C.

Provider Business Mailing Address
First Line	:	126 S JEFFERSON ST
Second Line	:
City	:	WOODSTOCK
State	:	IL
Zip	:	60098-3438
Country	:	US
Telephone Number	:	815-337-5500
Fax Number	:	815-337-5733

Provider Business Practice Location Address
First Line	:	126 S JEFFERSON ST
Second Line	:
City	:	WOODSTOCK
State	:	IL
Zip	:	60098-3438
Country	:	US
Telephone Number	:	815-337-5500
Fax Number	:	815-337-5733

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	06/16/2008

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Directions to “ DR. JOHN G MERKLING D.C.” Practice Location

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