Active NPI
Elsa Marquez Merin, M.D.
- Family Medicine Physician
- Forest Park,, IL
National Provider Identifier
1952494361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Practice address
- 7435 W. Madison St.
Forest Park,, IL 60130-1542 - Phone
- (708) 771-0250
- Fax
- (708) 771-0686
- NPI assigned
- Sep 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | IL | Primary |
Addresses
Primary practice location
7435 W. Madison St.
Forest Park,, IL 60130-1542
Mailing address
7435 Madison St
Forest Park, IL 60130-1542
Phone (708) 771-0250
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21605310 | Other | IL | BLUE CROSS ID# |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036051717 | IL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952494361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7435 MADISON ST",
"city": "FOREST PARK",
"state": "IL",
"postal_code": "601301542",
"telephone_number": "708-771-0250",
"fax_number": "708-771-0686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7435 W. MADISON ST.",
"city": "FOREST PARK,",
"state": "IL",
"postal_code": "601301542",
"telephone_number": "708-771-0250",
"fax_number": "708-771-0686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERIN",
"first_name": "ELSA",
"middle_name": "MARQUEZ",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS ID#",
"identifier": "21605310",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Forest Park,, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.