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NPI Code Detail

MEDICARE: MICHAEL J MERRY MD

MEDICARE: MICHAEL J MERRY 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
1207R00000XInternal Medicine Physician036074925IL

Other Identifiers

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

General Provider Information

NPI Number : 1477529675
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL J MERRY MD
Provider Business Mailing Address
First Line : 421 W EXCHANGE ST
Second Line : PO BOX 268
City : FREEPORT
State : IL
Zip : 61032-4030
Country : US
Telephone Number : 815-599-7950
Fax Number :
Provider Business Practice Location Address
First Line : 1010 FAIRWAY DR
Second Line :
City : FREEPORT
State : IL
Zip : 61032-6600
Country : US
Telephone Number : 815-599-7790
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2006
Last Update Date : 01/11/2026

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