Provider Demographics
NPI:1154697878
Name:MERLIN, GABRIEL (MD AS OF JUNE 2012)
Entity type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:MERLIN
Suffix:
Gender:M
Credentials:MD AS OF JUNE 2012
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 W HIGGINS RD
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60195-3203
Mailing Address - Country:US
Mailing Address - Phone:847-285-4200
Mailing Address - Fax:
Practice Address - Street 1:929 W HIGGINS RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60195
Practice Address - Country:US
Practice Address - Phone:847-285-4200
Practice Address - Fax:847-885-0130
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-144953207XS0106X, 207X00000X
NHLT4191207X00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program