Provider Demographics
NPI:1336184423
Name:HYLTON, MERCY (MD)
Entity Type:Individual
Prefix:
First Name:MERCY
Middle Name:
Last Name:HYLTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MERCY
Other - Middle Name:
Other - Last Name:MAKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4685 RELIABLE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60686-0001
Mailing Address - Country:US
Mailing Address - Phone:317-802-3173
Mailing Address - Fax:
Practice Address - Street 1:2001 W 86TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1902
Practice Address - Country:US
Practice Address - Phone:317-802-3173
Practice Address - Fax:317-870-0499
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01057695207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200816070Medicaid
IN200816070Medicaid
I53860Medicare UPIN
IN259240VMedicare PIN