Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 036107262 | IL |
Y | 207VG0400X | Gynecologist | 036-107262 | IL |
NPI | 1104928498 |
---|---|
Provider Name | Dr. Nahla O. Merhi |
First Address | New Lenox, IL 60451 |
Second Address | New Lenox, IL 60451 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 03/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036107262 | (05) | IL |
1401089841 | CLIA# (01) | IL |
H63589 | (02) | |
H63589 | (02) | IL |