Individual
MERRIE VISCARRA
Active
Individual
MERRIE VISCARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036113267
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036113267
—
IL
01
—
1633786
BCBS PROVIDER ID
IL
01
—
P00255743
RAILROAD MEDICARE
IL
Enumeration date
09/23/2005
Last updated
10/09/2018
Update your record
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