Individual provider Active NPI

Janice R Merkle, RN

  • Registered Nurse
  • Chicago, IL
National Provider Identifier
1154063873
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041.162867 Issued in IL
Practice address
3921 N Lincoln Ave
Chicago, IL 60613-2417
Phone
(312) 533-0707
NPI assigned
Apr 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.162867 IL Primary

Addresses

Primary practice location

3921 N Lincoln Ave
Chicago, IL 60613-2417

Mailing address

3921 N Lincoln Ave
Chicago, IL 60613-2417
Phone (312) 533-0707

Other identifiers 1

IdentifierTypeStateIssuer
041162867OtherILREGISTERED NURSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041.162867ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Nourishment Works PC CurrentSince Apr 17, 2022 Accepting new patients

Locations

3921 N Lincoln Ave
Chicago, IL 60613
Phone (312) 380-5344

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1154063873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3921 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132417",
            "telephone_number": "312-533-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132417",
            "telephone_number": "312-533-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERKLE",
        "first_name": "JANICE",
        "middle_name": "R",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.162867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "041162867",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.