Healthcare Provider Details

I. General information

NPI: 1124942719
Provider Name (Legal Business Name): EMILY ROSE KAHN-SHEAHAN MSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5317 N CLARK ST
CHICAGO IL
60640-2113
US

IV. Provider business mailing address

1525 E 53RD ST STE 623
CHICAGO IL
60615-4530
US

V. Phone/Fax

Practice location:
  • Phone: 312-725-9566
  • Fax:
Mailing address:
  • Phone: 312-725-9566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.129373
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: