Healthcare Provider Details

I. General information

NPI: 1376391383
Provider Name (Legal Business Name): EMMA LOUISE CALLAMARO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2024
Last Update Date: 08/20/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 S CALIFORNIA AVE # 7-140
CHICAGO IL
60608-1732
US

IV. Provider business mailing address

240 E HURON ST STE 1-200
CHICAGO IL
60611-2909
US

V. Phone/Fax

Practice location:
  • Phone: 773-542-2000
  • Fax:
Mailing address:
  • Phone: 312-503-1851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number085011388
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: