Jack Mersino

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1135 Skokie Blvd
Northbrook, IL 60062-4118

Phone

(847) 441-5600

NPI assigned

Aug 21, 2026

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1787270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1245146802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 LATROBE AVE",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 SKOKIE BLVD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624118",
            "telephone_number": "847-441-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 N Genesee St",
            "address_purpose": "LOCATION",
            "city": "Waukegan",
            "state": "IL",
            "postal_code": "600854262",
            "country_code": "US",
            "telephone_number": "847-441-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERSINO",
        "first_name": "JACK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-08-21",
        "last_updated": "2026-08-21",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Student in an Organized Health Care Education/Training Program in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Student in an Organized Health Care Education/Training Program in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; 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.