MEDICARE: DR. CHARLES W MERCIER 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	207X00000X	Orthopaedic Surgery Physician	036047588	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	200023832	OTHER	IL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	21606715	OTHER	IL	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	45543707	OTHER	IL	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1457320749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES W MERCIER MD

Provider Business Mailing Address
First Line	:	3000 N HALSTED ST
Second Line	:	#525
City	:	CHICAGO
State	:	IL
Zip	:	60657-5188
Country	:	US
Telephone Number	:	773-433-3130
Fax Number	:	773-433-3125

Provider Business Practice Location Address
First Line	:	3000 HALSTED ST
Second Line	:	SUITE 525
City	:	CHICAGO
State	:	IL
Zip	:	60657-9269
Country	:	US
Telephone Number	:	773-433-3130
Fax Number	:

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

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	10/12/2016

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Directions to “ DR. CHARLES W MERCIER MD” Practice Location

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