Robert E. Merrick, MD

Primary specialty

Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X

License

036054685 Issued in IL

Practice address

1633 W Berwyn Ave
Chicago, IL 60640-2005

Phone

(217) 848-7856

NPI assigned

Apr 6, 2007

Last updated

Feb 24, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1437272549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 W BERWYN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402005",
            "telephone_number": "217-848-7856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 W BERWYN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402005",
            "telephone_number": "217-848-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRICK",
        "first_name": "ROBERT",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "IL",
            "license": "036054685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036054685",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00115241",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "110123",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tova Meron
• Daniel Seth Merrick, MD
• Jillian Sari Merrick
• Kathryn Merrick, APRN
• Natalie Merrick, LCSW
• Addila Merrill, NP
• Krista Ann Merrill, LMT
• Maeanna Merrill, MD
• Michael H. Merrill, PHD, LCPC
• Nathan Merrill, PHARMD

• Clinical Pathology/Laboratory Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Pathology/Laboratory Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.