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General NPI Number Information
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NPI Number | 1194908095
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Entity Type | Organization
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Legal Business Name | CLAUDE E. MERRIN MD PC
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 01/15/2008
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Provider Practice Location Address
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Address Line | 4015 N PULASKI RD
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City | CHICAGO
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State | IL
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Zip | 60641-2456
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Country | US
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Telephone | 773-588-8855
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Fax |
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Provider Business Mailing Address
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Address Line | 4015 N PULASKI RD
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City | CHICAGO
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State | IL
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Zip | 60641-2456
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Country | US
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Telephone | 773-588-8855
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CLAUDE E MERRIN
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Credential | MD
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Telephone | 773-588-8855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State | IL
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