Healthcare Provider Details

I. General information

NPI: 1609187186
Provider Name (Legal Business Name): MONISH MERCHANT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2010
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 MAIN ST
HOBART IN
46342-4439
US

IV. Provider business mailing address

836 W WELLINGTON AVE LL
CHICAGO IL
60657-5147
US

V. Phone/Fax

Practice location:
  • Phone: 219-476-7246
  • Fax: 219-476-1713
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number75608
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD-54200
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number125058023
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number01079454A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: