Provider Demographics
NPI:1174900807
Name:MERRITT, SETH
Entity type:Individual
Prefix:MR
First Name:SETH
Middle Name:
Last Name:MERRITT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 W HUBBARD ST
Mailing Address - Street 2:SUITE 7S
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-8542
Mailing Address - Country:US
Mailing Address - Phone:312-800-3995
Mailing Address - Fax:
Practice Address - Street 1:116 W HUBBARD ST
Practice Address - Street 2:SUITE 7S
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-8542
Practice Address - Country:US
Practice Address - Phone:312-800-3995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-01
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor