Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 036126063 | IL |
N | 208600000X | Surgeon | 036126063 | IL |
Y | 2086X0206X | Surgical Oncologist | 036126063 | IL |
NPI | 1396968889 |
---|---|
Provider Name | Ryan P Merkow |
First Address | New York, NY 10065-6342 |
Second Address | Chicago, IL 60611-5975 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 06/06/2017 |