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1033849229

NPI Code Detail

MEDICARE: IAN DOUGLAS EMERICK DPT

MEDICARE: IAN DOUGLAS EMERICK DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	11274	SC
2	225100000X	Physical Therapist		AZ
3	225100000X	Physical Therapist	1393345	TX
4	225100000X	Physical Therapist		WA

General Provider Information

NPI Number	:	1033849229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IAN DOUGLAS EMERICK DPT

Provider Business Mailing Address
First Line	:	2001 BUTTERFIELD RD STE 1600
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15600 NE 8TH ST STE E6
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98008-4087
Country	:	US
Telephone Number	:	425-214-7679
Fax Number	:	425-201-0985

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2022
Last Update Date	:	03/21/2025

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Directions to “ IAN DOUGLAS EMERICK DPT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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