Healthcare Provider Details

I. General information

NPI: 1972563500
Provider Name (Legal Business Name): JOHN U. MERKEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 N PEARL ST
TEUTOPOLIS IL
62467-1134
US

IV. Provider business mailing address

1207 NETWORK CENTRE DR SUITE 3
EFFINGHAM IL
62401-4632
US

V. Phone/Fax

Practice location:
  • Phone: 217-857-6481
  • Fax: 217-857-6094
Mailing address:
  • Phone: 217-347-2707
  • Fax: 217-347-2827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036065845
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: