Healthcare Provider Details

I. General information

NPI: 1386516698
Provider Name (Legal Business Name): EMMA COVERT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 09/18/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5730 S DREXEL AVE
CHICAGO IL
60637
US

IV. Provider business mailing address

647 W ROSCOE ST APT CH
CHICAGO IL
60657-2900
US

V. Phone/Fax

Practice location:
  • Phone: 773-702-6169
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041558091
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: