MEDICARE: DR. WILLIAM MERRICK SANDERS MD

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	36090670	IL
2	207RP1001X	Pulmonary Disease Physician	36090670	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164426599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM MERRICK SANDERS MD

Provider Business Mailing Address
First Line	:	2845 N SHERIDAN RD
Second Line	:	STE 710
City	:	CHICAGO
State	:	IL
Zip	:	60657-7227
Country	:	US
Telephone Number	:	773-935-5556
Fax Number	:	773-935-2724

Provider Business Practice Location Address
First Line	:	2845 N SHERIDAN RD
Second Line	:	STE 710
City	:	CHICAGO
State	:	IL
Zip	:	60657-7227
Country	:	US
Telephone Number	:	773-935-5556
Fax Number	:	773-935-2724

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	12/23/2021

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