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NPI Code Detail

MEDICARE: JANICE R MERKLE RN

MEDICARE: JANICE R MERKLE RN
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
1163W00000XRegistered Nurse041.162867IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1041162867OTHERILREGISTERED NURSE

General Provider Information

NPI Number : 1154063873
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANICE R MERKLE RN
Provider Business Mailing Address
First Line : 3921 N LINCOLN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60613-2417
Country : US
Telephone Number : 312-533-0707
Fax Number :
Provider Business Practice Location Address
First Line : 3921 N LINCOLN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60613-2417
Country : US
Telephone Number : 312-533-0707
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2022
Last Update Date : 04/12/2022

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