Provider Demographics
NPI:1427246362
Name:NATHAN, MERLE ANN (MA)
Entity type:Individual
Prefix:
First Name:MERLE
Middle Name:ANN
Last Name:NATHAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 DEMPSTER ST STE 501
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-8429
Mailing Address - Country:US
Mailing Address - Phone:847-592-7725
Mailing Address - Fax:
Practice Address - Street 1:2604 DEMPSTER ST STE 501
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-8429
Practice Address - Country:US
Practice Address - Phone:847-592-7725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147000108237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter