Individual
O. KENT MERCADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
501 THORNHILL DR, #100, CAROL STREAM, IL 60188-2793
(630) 690-3338
(630) 690-3488
Mailing address
501 THORNHILL DR, #100, CAROL STREAM, IL 60188-2793
(630) 690-3338
(630) 690-3488
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004238
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004238
—
IL
01
—
60001691
BC/BS PROVIDER #
IL
Enumeration date
08/30/2006
Last updated
05/20/2013
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