Provider Demographics
NPI:1427398742
Name:MERRILL, NATHAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:
Last Name:MERRILL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2227 W SCHOOL ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-6321
Mailing Address - Country:US
Mailing Address - Phone:312-343-9559
Mailing Address - Fax:
Practice Address - Street 1:2227 W SCHOOL ST
Practice Address - Street 2:UNIT 1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-6321
Practice Address - Country:US
Practice Address - Phone:312-343-9559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051290655183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist