Healthcare Provider Details

I. General information

NPI: 1194787648
Provider Name (Legal Business Name): EMALEE G FLAHERTY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 09/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 CHILDRENS PLAZA BOX 16
CHICAGO IL
60614
US

IV. Provider business mailing address

2300 CHILDRENS PLAZA BOX 16
CHICAGO IL
60614
US

V. Phone/Fax

Practice location:
  • Phone: 773-880-3763
  • Fax: 773-281-4237
Mailing address:
  • Phone: 773-880-3763
  • Fax: 773-281-4237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036045658
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: