Provider Demographics
NPI:1821095589
Name:MERKLING, JOHN G (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:G
Last Name:MERKLING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-3438
Mailing Address - Country:US
Mailing Address - Phone:815-337-5500
Mailing Address - Fax:815-337-5733
Practice Address - Street 1:126 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-3438
Practice Address - Country:US
Practice Address - Phone:815-337-5500
Practice Address - Fax:815-337-5733
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038006525111N00000X
AR1129111N00000X
KY3962111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5682024OtherBC/BS PROVIDER NUMBER
ILT54228Medicare UPIN
IL913860Medicare PIN