Provider Demographics
NPI:1659558732
Name:MERKEL, FREDERICK KARL (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:KARL
Last Name:MERKEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:KENILWORTH
Mailing Address - State:IL
Mailing Address - Zip Code:60043-1214
Mailing Address - Country:US
Mailing Address - Phone:847-251-3780
Mailing Address - Fax:847-251-4760
Practice Address - Street 1:151 SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:KENILWORTH
Practice Address - State:IL
Practice Address - Zip Code:60043-1214
Practice Address - Country:US
Practice Address - Phone:847-251-3780
Practice Address - Fax:847-251-4760
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL204F00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AM3903994OtherDEA
AM3903994OtherDEA