Provider Demographics
NPI:1205041795
Name:MERCADO, PILAR R (MD)
Entity Type:Individual
Prefix:DR
First Name:PILAR
Middle Name:R
Last Name:MERCADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:PILAR
Other - Middle Name:REBECCA
Other - Last Name:MERCADO FULLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3846 N FRANCISCO AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-3504
Mailing Address - Country:US
Mailing Address - Phone:312-203-6504
Mailing Address - Fax:
Practice Address - Street 1:1740 W TAYLOR ST
Practice Address - Street 2:3200 W UICH MC 515
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-7232
Practice Address - Country:US
Practice Address - Phone:312-996-4020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology