Provider Demographics
NPI:1336117084
Name:MERWICK, PATRICIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:A
Last Name:MERWICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 PAYSHERE CIR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2135
Mailing Address - Country:US
Mailing Address - Phone:630-469-9200
Mailing Address - Fax:
Practice Address - Street 1:533 W NORTH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2135
Practice Address - Country:US
Practice Address - Phone:630-279-8771
Practice Address - Fax:630-279-8576
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036045874207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036045874Medicaid
IL036045874Medicaid
IL245170Medicare ID - Type Unspecified