Provider Demographics
NPI:1447749270
Name:ETHRIDGE, MERYL ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:MERYL
Middle Name:ELIZABETH
Last Name:ETHRIDGE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:9650 GROSS POINT RD STE 3900
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-5085
Mailing Address - Country:US
Mailing Address - Phone:847-570-1700
Mailing Address - Fax:847-982-1098
Practice Address - Street 1:9650 GROSS POINT RD STE 3900
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-5085
Practice Address - Country:US
Practice Address - Phone:847-570-1700
Practice Address - Fax:847-982-1098
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2024-09-09
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Provider Licenses
StateLicense IDTaxonomies
IL036171376208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery