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Individual

JUAN P MERCADO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APN

Contact information

Practice address
164 DIVISION ST, 607, ELGIN, IL 60120-5587
(847) 695-1093
(847) 695-0501
Mailing address
2943 W 71ST ST, CHICAGO, IL 60629-3047
(630) 842-2614

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209008311
IL

Other

Enumeration date
09/03/2010
Last updated
08/30/2011
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