Healthcare Provider Details

I. General information

NPI: 1073436630
Provider Name (Legal Business Name): EMILY WUNSCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6966 N ASHLAND BLVD APT 3E
CHICAGO IL
60626-3338
US

IV. Provider business mailing address

6966 N ASHLAND BLVD APT 3E
CHICAGO IL
60626-3338
US

V. Phone/Fax

Practice location:
  • Phone: 717-321-4754
  • Fax:
Mailing address:
  • Phone: 717-321-4754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: