Provider Demographics
NPI:1093145948
Name:NASSIF, MERIT (MD, FACOG)
Entity Type:Individual
Prefix:
First Name:MERIT
Middle Name:
Last Name:NASSIF
Suffix:
Gender:F
Credentials:MD, FACOG
Other - Prefix:
Other - First Name:MERIT
Other - Middle Name:SAMIR
Other - Last Name:EHSAN NASSIF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, FACOG
Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54702-1510
Mailing Address - Country:US
Mailing Address - Phone:715-838-3635
Mailing Address - Fax:
Practice Address - Street 1:1875 DEMPSTER ST STE 465
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1129
Practice Address - Country:US
Practice Address - Phone:732-642-3144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036139916207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology