| Marcus Mercer | |
|
5526 E Lake Dr A Lisle IL 60532-2691 | |
| (630) 373-6309 | |
| Not Available |
| Full Name | Marcus Mercer |
|---|---|
| Speciality | Dentist |
| Location | 5526 E Lake Dr, Lisle, Illinois |
| Authorized Official Name and Position | Marcus Mercer (OWNER) |
| Authorized Official Contact | 6303736309 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marcus Mercer 5526 E Lake Dr A Lisle IL 60532-2691 Ph: (630) 373-6309 | Marcus Mercer 5526 E Lake Dr A Lisle IL 60532-2691 Ph: (630) 373-6309 |
| NPI Number | 1487104188 |
|---|---|
| Provider Enumeration Date | 10/06/2016 |
| Last Update Date | 10/06/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487104188 | NPI | - | NPPES |
| 019018685 | Other | IL | STATE OF ILLINOIS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019018685 (Illinois) | Primary |
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