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Individual

LLOYD MERCADO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ANP

Contact information

Practice address
2331 W CHICAGO AVE, CHICAGO, IL 60622-4723
(773) 772-7858
(773) 276-6668
Mailing address
PO BOX 3603, OAK BROOK, IL 60522-3603

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209012347
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13677101
CAQH
IL
05
209-012347
IL
Enumeration date
01/05/2015
Last updated
03/07/2023
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