Individual
DR. MERLE S HOLLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EDD
Contact information
Practice address
2651 N. MAGNOLIA AVE., CHICAGO, IL 60614
(312) 515-9423
Mailing address
2651 N. MAGNOLIA AVE., CHICAGO, IL 60614-1213
(773) 935-0668
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071.007610
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1600869
BLUE CROSS BLUE SHIELD OF ILLINOIS
IL
Enumeration date
09/21/2006
Last updated
07/10/2012
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